[Methods of optimizing and objective criteria for evaluating the efficacy of chemo-surgical treatment of malignant epithelial tumors of the ovaries]

In a group of 811 patients with epithelial malignancies of the ovaries, the diagnostic and therapeutic procedures used were either standard or they involved elements of optimization based on certain objective criteria. The reliability of diagnosis and treatment efficacy in the two subgroups were compared. Stage I-II tumors made up 37.1% of neoplasms diagnosed at regular check-ups and 16.9% of those identified in controls. Duration of relapse-free period was 45.0 and 11.8 months whereas five-year survival rate--42.9% and 20.5%, respectively. Clinically inapparent recurrence was cytologically detected in 29.5% of "actively" followed patients. Additional estrogen and progestin therapy assured an increase in recurrence-free period from 13.5 to 20.6 months in patients with stage III-IV tumors (9.1 and 9.5 months in controls). The efficacy of single-agent and combination chemotherapy in stage III-IV cancer was nearly the same. Adjuvant postoperative chemotherapy administered during the first 2.5-3 years of remission resulted in a 2.2--fold decrease in recurrence rate and a 21.4% rise in five-year survival rate in patients with stage Ia and Ib cancer.