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Long-term survival in a randomized study of nonplatinum therapy versus platinum in advanced epithelial ovarian cancer
  1. M. O. Nicoletto*,
  2. S. Tumolo,
  3. R. Sorio,
  4. G. Cima§,
  5. L. Endrizzi,
  6. O. Nascimben,
  7. O. Vinante#,
  8. G. Artioli*,
  9. M. Donach* and
  10. G. Cartei*
  1. * U.O.C. Medical Oncology Department, Istituto Oncologico Veneto, Padua, Italy;
  2. Medical Oncology Department, Ospedale Santa Maria degli Angeli, Pordenone, Italy;
  3. Medical Oncology Department, Centro di Riferimento Oncologico, Aviano, Pordenone, Italy;
  4. § U.O.C. Ostetricia e Ginecologia, Viareggio, Italy;
  5. Struttura Complessa di Oncologia Medica, Ospedale di Bassano, Vicenza, Italy;
  6. Medical Oncology Department, Ospedale Civile di Mestre, Venice, Italy; and
  7. # C.O.M. Ospedale P.F. Calvi, Noale, Treviso, Italy
  1. Address correspondence and reprint requests to: Maria Ornella Nicoletto, MD, Oncologia Medica, Istituto Oncologico Veneto, Ospedale Busonera, Via Gattamelata 64, 35128 Padova, Italy. Email: mariaorn{at}


The purpose of this study was to compare long-term survival in first-line chemotherapy with and without platinum in advanced-stage ovarian cancer. From July 1987 to November 1992, 161 untreated patients with FIGO stage III–IV epithelial ovarian cancer were randomized: 81 patients received no platinum and 80 received platinum combination. Residual disease after surgery was <2 cm in 61 patients without platinum, 59 with platinum. Median age was 58 years in nonplatinum arm and 55 years in platinum arm (range: 15–73). Complete and partial responses were 51% and 10% for nonplatinum arm and 51% and 8% for platinum arm, respectively (P= 0.7960). Stable disease was observed in 18% of patients in nonplatinum arm and 15% of patients in platinum arm and progression in 20% of nonplatinum- and 21% of platinum-treated cases. Ten-year disease-free survival was 37% for therapy without platinum and 31% for platinum combination (P= 0.5679); 10-year overall survival was 23% without platinum and 31% with platinum combination (P= 0.2545). Fifteen-year overall survival showed a trend of short duration in favor of platinum (P= 0.0678). Relapses occurred after 60 months in ten patients (seven with and three without platinum). The overall and disease-free survivals at 5, 10, and 15 years show no statistically significant long-term advantage from the addition of cisplatin; however, there is a slight trend in its favor.

  • first-line
  • long-term survival
  • ovarian cancer
  • platinum
  • randomized

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