Adjuvant treatment with melphalan in ovarian carcinoma with no residual disease following surgery

Abstract

Forty-nine patients classified after surgery and complete non-surgical restaging as "no residual disease" were treated with adjuvant chemotherapy. Thirty-nine patients had ovarian carcinoma and 10 borderline tumors. All patients had geographic inaccessibility. Domiciliary treatment with melphalan at the dose of 10 mg/day p.o. for 5 consecutive days every 4 weeks for 12 cycles was used. Within 6 months from the end of adjuvant treatment a second restaging with peritoneoscopy and peritoneal cytology was performed. The median administered dose of melphalan was 575 mg. No patient with a borderline tumor relapsed. Nine patients with ovarian carcinoma relapsed (23%): 4/10 at stage II-III and 5/29 (17%) at stage I. The relapse-free survival at 96 months was 77% for stage I patients and 73% for all patients. The overall survival was 87% for stage I patients and 81% for all patients. Mild myelo-depression was evident in 65% of patients. No case of acute nonlymphocytic leukemia was observed.