Stage III epithelial ovarian cancer: the role of maximal surgical reduction.

One hundred forty-two cases of ovarian cancer of epithelial origin treated at Georgetown University Hospital between 1974 and 1980 were analyzed. Seventy-five patients (52.8%) were found to have Stage III disease at the time of the initial laparotomy, and the purpose of this study was to assess the outcome of the management in this group of patients. In spite of an aggressive approach, complete tumor excision could only be affected in 13 of the 75 Stage III cases (17.3%). Residual disease of less than 2 cm was achieved in a further 8 cases (10.7%). The ability to perform complete tumor clearance bore no relationship to the grade of the tumor. The survival rate in the complete clearance group was 100% with a mean survival time of 45 months (range 10-90 months) and 10 of these patients have been shown to be free of disease by second-look laparotomy. The outcome in terms of survival and disease-free status in these two groups of patients was unaffected by various chemotherapy regimens and the only factor of importance appeared to be the success of the initial surgery in clearing the disease.