Adjuvant Treatment with Melphalan in Ovarian Carcinoma with no Residual Disease following Surgery

Forty-nine patients classified after surgery and complete non-surgical restaging as « no residual disease » were treated with adjuvant chemotherapy. Thirty-nine patients had ovarian carcinoma and 10 borderline tumors. All patients had geographic inaccessibility. Domiciliary treatment with melphalan at the dose of 10 mg/day p.o. for 5 consecutive days every 4 weeks for 12 cycles was used. Within 6 months from the end of adjuvant treatment a second restaging with peritoneoscopy and peritoneal cytology was performed. The median administered dose of melphalan was 575 mg. No patient with a borderline tumor relapsed. Nine patients with ovarian carcinoma relapsed (23 %): 4/10 at stage II-III and 5/29 (17 %) at stage I. The relapse-free survival at 96 months was 77 % for stage I patients and 73 % for all patients. The overall survival was 87 % for stage I patients and 81 % for all patients. Mild myelodepression was evident in 65 % of patients. No case of acute nonlymphocytic leukemia was observed.