THE VALUE OF POSTOPERATIVE INTRAPERITONEAL INJECTION OF RADIOCOLLOIDS IN EARLY CANCER OF THE OVARY

1. From April 1956 to September 1965, 57 patients with Stage I cancer of the ovary (as defined by the International Federation of Gynecologists) were treated at Memorial Hospital. The over-all 5 year survival rate of these patients is 78 per cent (44/57).

2. Radioactive colloidal phosphorus (P³²) was used in 26 patients (46 per cent of all patients). The 5 year survival rate for the patients with and without P³² is 92 per cent (24/26) and 64 per cent (20/31), respectively.

3. There is no evidence of any major adverse effect, either in the postoperative period or at a later date, attributable to the instillation of P³².

4. Because of the small number of patients, no definite conclusions can be formed at this time regarding the value of omentectomy. A controlled prospective study, therefore, appears desirable in order to investigate this question.

5. It appears that the postoperative instillation of P³² decreases the incidence of local (intra-abdominal) recurrences, but owing to the small number of patients, no definite conclusions can be drawn.

6. A controlled prospective study on a nation-wide basis is advisable in order to determine the value of radiocolloids in early cancer of the ovary, since only a small number of patients of this type are seen at any one institution. On the basis of our preliminary results, we at Memorial Hospital are presently using colloidal P³² immediately postoperatively in all patients with Stage I cancer of the ovary; in Stage II, the patients are randomized following surgery for radioactive phosphorus plus external pelvic irradiation versus chemotherapy alone.

The main argument for the use of colloidal phosphorus postoperatively is the simplicity of administration and the absence of severe side reactions and late effects, which are associated with the use of total abdominal irradiation.

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