Intravenous Chemotherapy, Early Debulking Surgery, and Consolidation Intraperitoneal Chemotherapy in Advanced Ovarian Carcinoma

Objective. The efficacy of a cisplatin–anthracycline combination, early debulking surgery, and intraperitoneal chemotherapy has been demonstrated through separate studies. We evaluated a multimodal treatment strategy integrating these therapeutic options. Methods. Women with stage III or IV ovarian carcinoma received six cycles of cisplatin/epirubicin alternating with leucovorin and 5-fluorouracil. Patients with a residual disease (RD) measuring more than 2 cm after the initial laparotomy underwent an early debulking surgery after the first three cycles of chemotherapy. A second-look laparotomy (SLL) was performed after six cycles of intravenous chemotherapy. Intraperitoneal chemotherapy with cisplatin, VP16, and mitoxantrone was then administered in patients with no or RD 2 cm. After early debulking surgery, an additional 18 patients (21%) had a RD