Patterns of first recurrence following adjuvant intraperitoneal chemotherapy for stage IIIC ovarian cancer

ObjectiveAdjuvant intraperitoneal (IP) platinum-based chemotherapy has been shown to improve outcome for patients with advanced ovarian cancer. We hypothesize that patients who have received adjuvant IP chemotherapy more commonly recur first at extraperitoneal sites than patients who have received adjuvant intravenous (IV) chemotherapy.MethodsPatients with newly diagnosed stage IIIC optimally debulked serous ovarian cancer were identified from institutional databases. Patterns of recurrence were compared between patients who received IV and IP chemotherapy using standard two-sided statistical tests.ResultsOf the 104 patients who met inclusion criteria, 60 received IV chemotherapy and 44 received IP chemotherapy. Patients in the IV group had a first recurrence more commonly in the lower abdomen or pelvis than the IP group. Patients in the IP group more commonly recurred in the upper abdomen and extra-abdominal lymph nodes. More patients in the IP group than the IV group recurred at extra-abdominal sites (45.5% versus 23.3%, P = 0.018).ConclusionsPatients receiving adjuvant IP chemotherapy are less likely to first recur in the lower abdomen or pelvis and more likely to recur outside of the abdominal cavity. The data suggest that IP chemotherapy is highly effective in the anatomic areas of peritoneal distribution.

► Patients receiving IV chemotherapy alone are more likely to recur in the pelvis than patients receiving combination IV/IP chemotherapy. ► Patients receiving combination IV/IP chemotherapy are more likely to recur in the upper abdomen and in extra-abdominal sites. ► IP chemotherapy is highly effective in the anatomic areas of peritoneal distribution.