Complications of surgery can include infection, bleeding and injury to the bladder, rectum or ureter causing a leak, although this is rare. There may be blood clots in the legs, which can occasionally dislodge and travel to the lungs (pulmonary embolism).
Chemotherapy In most cases the chemotherapy is begun one to two weeks after surgery. The
standard regimen includes cisplatin or carboplatin + Cytoxan , or cisplatin + Taxol given intravenously every three to four weeks as tolerated for at least six cycles. Forty to 80 percent of patients can be expected to respond. The response rate depends to a large degree on the amount of cancer remaining after surgery, with those who have an optimal tumor debulking having a better response rate.
Carboplatin is now being used more often than cisplatin because it can sometimes be given on an outpatient basis. It causes less kidney damage, hearing loss, nausea and vomiting and peripheral nerve damage (manifested by muscle weakness and numbness or tingling). Unfortunately, it does have more bone marrow toxicity than cisplatin. Cisplatin + Cytoxan and carboplatin + Cytoxan appear to have equal response rates. Cisplatin + Taxol may have a slightly higher response rate.
Over the past several years, a technique known as intraperitoneal (intra-abdominal) chemotherapy has been developed to deliver the chemotherapy directly into the abdominal cavity. This procedure requires surgery to place a port and its attached catheter beneath the skin. The catheter is brought through the abdominal wall and placed directly into the abdominal cavity. The cancer drugs are then given via a needle directly into the
