Therapeutic, clinical and histological factors related to the survival of patients with advanced ovarian carcinoma

Retrospective evaluation of 137 patients with advanced ovarian carcinoma was attempted 4-12 years after therapy. The operation was radical or almost radical in 56 cases (40.8%). Postoperative treatment consisted of single-drug (N = 53) or multi-drug cytotoxic chemotherapy (N = 53) and irradiation alone (N = 8) or together with cytotoxic chemotherapy (N = 53). Postoperative therapy of any kind was impossible in 23 cases. Nine patients were alive 5 years after therapy. Eight of them had had a clinical stage III (survival rate 7.7%) and one clinical stage IV malignancy (survival rate 3.0%). The extent of the operation was of major importance, 8 out of 9 survivors having undergone a radical operation, which also prolonged the life of the non-survivors. Single drug chemotherapy and combination chemotherapy yielded similar results, 4 and 5 survivors, and 21.1 and 19.6 months as the mean length of survival respectively. None of the patients on postoperative radiotherapy survived. Their mean survival period was 16.6 months. Radiotherapy as an additional measure did not produce any benefit. The prognosis was most favourable for patients with serous cystadenocarcinoma. A poor prognosis was typical of nulliparous women, suggesting that hormones may contribute to the clinical behaviour of this illness.