Das Ovarialkarzinom — Alte Probleme, neue Hoffnungen

  • A. Pfleiderer
Conference paper

Ovarian Carcinoma, Old problems, New hopes


Survey of actual developments in therapy of ovarian carcinoma presented and discussed in 15th UICC congress. Main topics of therapy of ovarian cancer are prognostic relevant factors, extension and radicality of operation and new developments in systemic therapy. Concerning prognostic relevant factors three systems have to be distinguished: factos for resectability of tumor, for response to chemotherapy and for survival. The size of postoperative tumor residual is considered to be the essential factor for survival. A multivariate analysis of data of the prospective GOCA multicenter study in ovarian cancer stage III reveals extension to diaphragma and to gastrocolic omentum as the most significant independent prognostic factors for resectability. Measurement of ploidy and length of S-phase give a hint for survival, analysis of growth factors and oncogenes indicate response to chemotherapy. Tumors of low malignant potenial are a special entity. The few malignant forms are detected by cytophotometry. Conservative treatment is recommended. Corresponding to macroscopic visible extension 773 cases of ovarian cancer are analyzed for result of further treatment. In case of free mobile tumors without visible metastases a fertility preserving operation can be discussed for younger patients. In case of locally invasive or adherent growth without visible metastases outside small pelvis, and in case of extension to upper abdomen without massive peritoneal carcinosis, radical operation, lym-phnodes included, is recommended, is possible in most cases and will increase survival rate. In case of a massive peritoneal carcinosis chemotherapy must be first choice of treatment. The preceding operation is important for diagnosis, for resection of tumor mass and improves survival rate within the first years. Concerning chemotherapy, reduction and therapy of side effects are actual problems. In the multicenter study of GOCA, carboplatin proves to be less toxic concerning nephro- and neurotoxicity, yet more aggressive for bone marrow than cisplatin. Early recurrences, however, seem to be more frequent. There are interesting developments in prophylaxis of emesis and neurotoxicity of cisplatin. Escalation of dosage of cytostatics, however, improves remission rate, not survival. Immunotherapy gives some hope, but no real new way.


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  1. 1.
    Bauknecht T (1990) Growth factors and their receptors as a sign for malignant potential of a special tumor. J Cancer Res Clin Oncol 116:1079Google Scholar
  2. 2.
    Bell DA (1990) Histologic features of ovarian serous borderline tumors and their relation to prognosis. J Cancer Res Clin Oncol 116:1234Google Scholar
  3. 3.
    Bianchi WA, Favalli G, Chiari S, Zanetta G, Marzola M, Mangioni C (1990) Fertility preserving in epithelial ovarian cancer. J Cancer Res Clin Oncol 116:1078Google Scholar
  4. 4.
    Braly PS (1990) Morphometrics: The prognostic test of the 1990’s. J Cancer Res Clin Oncol 116:1221Google Scholar
  5. 5.
    Burghardt E, Lahousen M, Stettner H (1989) The significance of pelvic and paraaortic lym-phadenectomy in the operative treatment of ovarian cancer. In: Burghardt E, Monaghan JM (eds) Operative treatment of ovarian cancer. Bailhere Tindall, London, pp 157–166Google Scholar
  6. 6.
    Creasman WT (1990) Critical analysis of prognostic factors in ovarian cancer. J Cancer Res Clin Oncol 116:1221Google Scholar
  7. 7.
    DuBois A, Meerpohl HG, Quaas L, Pfleiderer A (1990) Antiemesis mit 5-HT3-Antagonisten bei therapiefraktärem Erbrechen unter Cisplatin-Therapie. Ber Gyn 127:1048Google Scholar
  8. 8.
    Fox H (1990) Pathology of borderline tumors. Referat UICC-Kongreß 19. 8. 90 HamburgGoogle Scholar
  9. 9.
    Fox H (1990) The problem of malignant potential of epithelial ovarian tumors. Referat UICC-Kongreß 21. 8. 90 HamburgGoogle Scholar
  10. 10.
    Friedlander M (1990) Flow cytometric analysis of DNA content in borderline ovarian tumors. J Cancer Res Clin Oncol 116:1036Google Scholar
  11. 11.
    Griffiths CT (1990) Radicality in ovarian cancer stage III and IV. J Cancer Res Clin Oncol 116:1078Google Scholar
  12. 12.
    Heintz APM (1990) Tumor residual: A prognostic relevant factor? J Cancer Res Clin Oncol 116:1078Google Scholar
  13. 13.
    Meerpohl HG, Kühnle H, Sauerbrei W, Achterrath W, Pfleiderer A (1990) Cyclophospha-mide/Cisplatin vs Carboplatin in advanced ovarian carcinoma: A randomized multicenter study. J Cancer Res Clin Oncol 116:1120Google Scholar
  14. 14.
    Meerpohl HG, Sauerbrei W, Schumacher M, Pfleiderer A (1990) Welche Parameter beeinflussen die Größe des postoperativen Tumorrestes beim Ovarialkarzinom? Ber Gyn 127:931Google Scholar
  15. 15.
    Pfleiderer A, Meerpohl HG, Sauerbrei W, Teufel G, Schumacher M (1990) Are there different types of ovarian cancer? J Cancer Res Clin Oncol 116:1077Google Scholar
  16. 16.
    Tropé C (1990) DNA content as a prognostic index in borderline tumors of the ovary. J Cancer Res Clin Oncol 116:1036Google Scholar
  17. 17.
    Volm M, Kleine W, Pfleiderer A (1989) Flow-cytometric prognostic factors for the survival of patients with ovarian carcinoma:a 5-year followup study. Gynecol Oncol 35:84–89PubMedCrossRefGoogle Scholar
  18. 18.
    Wiltshaw E (1990) High-dose carboplatin with or without cisplatin-efficacy and toxicity in ovarian carcinoma stage IV. J Cancer Res Clin Oncol 116:1120Google Scholar
  19. 19.
    Winter R (1990) Lymphadenectomy with therapeutic intention. J Cancer Res Clin Oncol 116:1078Google Scholar

Copyright information

© Springer-Verlag, Berlin Heidelberg New York 1991

Authors and Affiliations

  • A. Pfleiderer
    • 1
  1. 1.Universitäts-FrauenklinikFreiburg/BrsgDeutschland

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