From the Department of Obstetrics and Gynecology, University of Oklahoma, Oklahoma City, OK
Authors’ disclosures of potential conflicts of interest are found at the end of this article.
Address reprint requests to Joan L. Walker, MD, Chair, Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, P.O. Box 26001, Oklahoma City, OK 73104; e-mail: joan-walker{at}ouhsc.edu
Overview: This review describes the current state of science for optimal and completely resected stage III epithelial carcinoma, including ovarian, fallopian tube, and peritoneal. The patient suspected to have ovarian cancer should be counseled by a gynecologic oncologist to undergo complete surgical resection and intraperitoneal (IP) catheter placement. Patients who have recovered adequately from surgery, as evidenced by resumed bowel function and oral nutritional intake, can proceed to chemotherapy. The recommended standard regimen is day 1 24-hour infusion of IV paclitaxel (PTX) 135 mg/m2, day 2 IP cisplatin (CDDP) 100 mg/m2, and day 8 IP PTX 60 mg/m2 (Gynecologic Oncology Group [GOG] 172 IP regimen) administration or enrollment on a clinical trial. Compromises to these principles may decrease survival. The most appropriate alternative to the GOG 172 IP regimen when the patient is considered a poor candidate for IP CDDP is the standard arm of GOG 1821 regimen of IV carboplatin area under the concentration curve (AUC) 6 and 3 hour IV PTX 175 mg/m2.
