Maximal cytoreduction, chemotherapy and contact nonspecific immunotherapy for stage III carcinoma of the ovary.

: A combination of therapeutic modalities was studied in 38 consecutive patients with intra-abdominally disseminated carcinoma of the ovary. Resection or destruction by electrocoagulation of all visible tumor was possible in 12 patients. Intra-abdominal chemotherapy and immunotherapy were given postoperatively and were continued systemically for one year. Serious postoperative complications and deaths did not occur. Five patients are well at 12, 22, 26, 34 and 49 months, and two are alive with disease at ten and 22 months. For 18 of the remaining 26 patients in group 2, elimination of all visible tumor was not possible technically, and in eight patients in group 3, an irresectable tumor was found. All of these patients received cyclic chemotherapy as those in group 1 but without immunotherapy. Patients in group 2 had a median survival time of about 16 months, no long term survivors and a mortality of 75 per cent at two years. The patients in group 3 had a median survival period of less than three months and were all dead before the end of the first year. Our results in this group are similar to those recently reported by others for patients with equally advanced disease treated by chemoimmunotherapy. Maximal tumor cytoreduction may be the most important of all the treatments we used, and a prerequisite to successful chemotherapy and immunotherapy. Contact nonspecific immunostimulation in this setting appears to be sound and safe and warrants further study to determine its ultimate contribution to patient survival.