Salvage intraperitoneal therapy of advanced epithelial ovarian cancer: impact of retroperitoneal nodal disease.

Overview

PURPOSE: The objective of this study was to evaluate the impact of retroperitoneal lymph node disease on the efficacy of salvage intraperitoneal (IP) chemotherapy for advanced epithelial ovarian cancer. METHODS: We retrospectively reviewed the records of 41 patients with advanced epithelial ovarian cancer treated between 9/83-7/95, who had undergone retroperitoneal nodal sampling prior to salvage intraperitoneal chemotherapy. RESULTS: Of the 41 patients treated with debulking surgery and platinum-based chemotherapy, 19 (46%) had disease noted in retroperitoneal lymph nodes at initial surgery or at reassessment laparotomy, while 22 (54%) had biopsy-proven negative nodes. The mean age of the node-positive group was 49 years. Residual disease prior to initiation of IP therapy was optimal (< or = 2 cm) in 16 patients and suboptimal in 3. Twenty-two patients with a mean age of 55 were found to be node-negative. Residual disease prior to initiation of intraperitoneal therapy was optimal (< or = 2 cm) in all 22 patients. All patients received salvage intraperitoneal chemotherapy. With a median follow-up of 26 months since surgical reassessment, the median survival in the node-positive group is 31 months compared to 40 months for the node-negative group (p = 0.47). CONCLUSIONS: The presence of retroperitoneal nodal disease does not appear to be a contraindication to the use of salvage IP chemotherapy in advanced ovarian cancer.