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Primary or delayed debulking surgery and chemotherapy consisting of cisplatin, doxorubicin, and cyclophosphamide in stage III-IV epithelial ovarian carcinoma.

Eighty-eight previously untreated patients with stage III and IV epithelial ovarian carcinoma were treated with primary or delayed (secondary) optimal debulking surgery unless impossible, and combination chemotherapy consisting of cisplatin, doxorubicin, and cyclophosphamide intravenously (IV) on day 1, every 4 weeks (CAP-I). In patients with no evidence of disease after six cycles of chemotherapy, a second-look laparotomy was performed. A pathologically confirmed complete response (CR) was obtained in 39% of the patients. The median progression-free survival period of all patients was 18 months and the median survival time 24 months. CAP-I is an effective chemotherapy schedule that can be administered with moderate toxicity and appears to enhance the cure rate in advanced ovarian carcinoma. The role of secondary surgery must be further defined.