Treatment of advanced ovarian cancer

: Forty patients with stage III or IV ovarian epithelial carcinoma, mean age 61 +/- 12 years, were treated either with cyclophosphamide-methotrexate-5-FU or with cisplatinum-adriamycin-5-FU-hexamethylmelamine. Median survival from initial surgery was 16 months, 18 months in stage III and 2 months in stage IV disease. 15 patients over 70 years had a median survival of 9 months. Median survival was higher with the regimen without cisplatinum (18 months against 13 months). Clinical response rate was 62.5%. Ten patients clinically free of disease underwent second look laparotomy which showed persistent disease in six. Based on these results and on a review of the literature, a new therapeutical approach is discussed.