Prognosis is known to be dramatically influenced

by cytoreductive surgery and response to adjuvant platinum/taxane-based chemotherapy. However, even good responders to initial treatment often have a poor Selleck NVP-HSP990 prognosis due to secondary relapse. Such relapses are generally chemoresistant and remain the major cause of death. Thus, it may be useful to treat chemosensitive patients in order to kill residual clones and avoid the chemoresistant relapse. Different consolidation therapies have been considered: conventional maintenance chemotherapy, intraperitoneal treatment with chemotherapy and/or hyperthermia, and HDC with HSCS. The latter has been widely used in the context of poor risk hematological malignancies and sometimes in chemosensitive solid tumors such as metastatic breast cancer [21–25] or germ cell tumors [26] with controversial results. The main toxicity of high-dose alkylating

agents is hematological. Stem cell transplantation is needed in such treatment strategies to limit the duration and consequences of aplasia. Nevertheless, severe infection can always occur during grade 4 neutropenia and remains the major potential risk during severe aplasia. However we observed no toxic death after HDC in this study. Several promising but preliminary studies have reported that HDS plus HSCS may improve ovarian cancer outcome in first-line therapy. These results were observed when HDC was used either as front-line treatment [19, Selleckchem NU7026 27], or as consolidation therapy [17, 28–32]. However published randomized phase III trials did not confirm these results. In a single center small-sized study from Papadimitriou et al.[19], although PFS was numerically improved by HDC (85.2 months versus 18 months),

the difference was not significant (p=0.059). Moreover, no significant difference was observed in OS (not reached after 75 months of follow-up versus 75 months, p=0.38). The authors attributed PFS gain to the higher rates of stages IV (14% vs. 8.1%) and larger post-operative Tenoxicam residue (32.6% vs. 21.6%) in the conventional therapy arm. Mobus et al. reported similar findings in their relatively large phase III trial published in 2007 [20]. Median PFS was 29.5 months in the HDC arm versus 20.5 in the control arm (p=0.40). There was also no difference regarding OS (54.4 vs. 62.8 months, p=0.54). Conclusions of these studies were that HDC does not improve outcome in advanced ovarian cancer. Nevertheless a question that could be asked is: are these conclusions relevant for all patients or is there a subset of patients who may benefit from HDC? In this retrospective study, we tried to address this issue using a subgroup analysis HKI272 approach in a large population of more than 160 patients.