Considerations for the management of a partially platinum-sensitive relapse (6-12 months)
Bradley J. Monk, MD

A 53-year-old otherwise healthy woman with positive family history for breast cancer (mother, sister, and aunt) underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor debulking for a stage IIIC, poorly differentiated serous ovarian cancer. She was suboptimally cytoreduced (residual gross disease >1 cm). She received 6 courses of paclitaxel + carboplatin. Her CA125 level normalized at the completion of chemotherapy, when she was clinically free of disease.

• Clinical course: 6 months following completion of chemotherapy, her CA125 was 56 U/mL and continued to rise over the next 3 months to 232 U/mL, when she also developed abdominal discomfort.
• Radiology: CT scan of abdomen/pelvis demonstrated a new right paraaortic mass and several areas of thickening along her anterior abdominal wall.
• Labs: CBC, liver, and renal function tests WNL
• ECOG performance status: 1

Based on extent of disease at diagnosis and experience of prior unsuccessful debulking, her gynecologist does not recommend secondary surgical debulking.