Intraperitoneal chromic phosphate therapy after second‐look laparotomy for ovarian cancer

Between 1973 and 1985, 118 patients in clinical remission after initial surgery and postoperative chemotherapy for epithelial ovarian carcinoma underwent second‐look laparotomy at the University of North Carolina. No evidence of disease (NED) was found in 57 of these patients; 43 patients received 15 mCi of radioactive chromic phosphate (³²P) suspension given intraperitoneally in the immediate postoperative period. In 29 other patients, only microscopic or minimal residual disease (nodules < 2 cm in size) was found, seven received ³²P alone, ten received ³²P and further chemotherapy, and 12 received chemotherapy alone. The 4‐year postsecond‐look survival of the patients with NED at second‐look was 89% for those receiving ³²P and 67% for those who had not. The respective figures for patients with minimal residual disease at second‐look are 59% versus 22%. Irrespective of treatment, a group at high risk for failure after negative second‐look laparotomy has been identified; those with an initial International Federation of Gynecology and Obstetrics (FIGO) stage >I and histologic grade >1. A comparison of our data with 18 previously published series, indicates that use of postsecond‐look intraperitoneal ³²P can improve the progression‐free interval, and possibly overall survival, of patients with NED or minimal residual disease without adding significant complications.