A study of the treatment of ovarian carcinoma.

Between 1970 and early 1980, 213 patients were treated for ovarian carcinoma (stages Ib-IV) at the Department of Obstetrics and Gynecology, Graz University Medical School. Until mid 1976 patients were given postoperative radiotherapy; after that they were given combination chemotherapy (adriamycin and cyclophosphamide) according to Lloyd or Parker [18, 20, 21]. An analysis of the results led to the following conclusions: The operability at primary surgery is of prime importance, the best survival rates (regardless of postoperative management) being obtained in those patients in whom it is possible to do a pelvic clearance (removal of uterus, tubes and ovaries) with omentectomy. In patients who were operable postoperative chemotherapy was markedly superior to radiotherapy in terms of 1 year survival. But only slightly superior at 2 and 5 years. On the other hand, in patients who had palliative surgery postoperative radiotherapy seemed to give slightly better survival figures. Patients with early carcinoma (up to stage IIa) survived longer than those with late stages of carcinoma (IIb-IV) whether operable or not). The histology of the tumour had no discernible influence on the result both of chemotherapy and of radiotherapy. The patients with endometrioid and mucinous carcinomas had the highest survival rates irrespective of the postoperative treatment. However, the patients with serous cystadenocarcinomas survived longer than those with immature solid carcinomas. Patients who had no tumour at a second-look operation lived longer than those who had tumour at this time. Patients whose tumour recurred after the completion of postoperative radiotherapy and who were then given chemotherapy had the highest survival rates regardless of whether nor not the carcinoma was originally operable. It is felt that radiotherapy followed by chemotherapy should be used routinely especially in patients with late stages of ovarian carcinoma.