From 1974-1990, 23 women with stage I and five with stage II
epithelial ovarian carcinoma received intraperitoneal
chromic phosphate (32P) as the only form of adjuvant
therapy after complete debulking and comprehensive surgical staging
laparotomy. Surgery consisted of total abdominal
hysterectomy with bilateral
salpingo-oophorectomy, omentectomy, peritoneal washings for cytology, multiple biopsies of pelvic and abdominal peritoneum, and selective pelvic and para-aortic
lymphadenectomy. Intraperitoneal 32P
therapy was administered a median of 7 days after
laparotomy. Significant toxicity was minimal; none of these patients required surgery for bowel obstruction. Overall 5-year survival was 90 and 100%, but disease-free survival was only 65% (95% confidence interval [CI] 36-86%) and 60% (95% CI 12-81%) for patients with stage I and II disease, respectively. Two patients developed intraperitoneal and six systemic relapses; all patients received
cisplatin regimens after relapse. Univariate analysis of age, stage, histology,
Ovarian Cancer Study/Gynecologic Oncology Group risk status, lesion size, and presence or absence of capsular adhesions revealed that only an age of 50 or more years had an adverse effect on disease-free survival (P less than .03). This study suggests that determination of early-stage disease and host-
tumor biology may be the most important factors in determining the survival of women with early
ovarian cancer defined by comprehensive surgical staging. Intraperitoneal 32P does not appear to be effective adjuvant
therapy in these women.