Fifty-eight stage III patients treated at The Jikei University Hospital were analysed retrospectively, in order to clarify the combination effect of maximal cytoreductive surgery and high dose cisplatin based chemotherapy in advanced ovarian cancer. They were divided into 4 groups by treatment they received which was as follows: Group A (n = 25); total abdominal hysterectomy (TAH), bilateral salpingooophorectomy (BSO) and omentectomy (OMTX) done at primary surgery and followed by 5 courses of "low dose" CAP therapy (cyclophosphamide 200 mg/sq m, adriamycin 20 mg/sq m, cisplatin 35 mg/sq m every 4 weeks for 5 courses). Group B (n = 4); TAH, BSO and OMTX carried out at primary surgery and followed by "high dose" CAP therapy (cyclophosphamide 200 mg/sq m, adriamycin 20 mg/sq m, cisplatin 70 mg/sq m, every 4 weeks for 5 courses and every 8-12 weeks for 5 courses thereafter). Group C (n = 13) received TAH, BSO and OMTX at the primary operation and paraaortic and pelvic lymphadenectomy (LNX) at the second look operation (SLO) with "high dose" CAP therapy as did Group B. Group D (n = 16), TAH, BSO, OMTX, LNX with maximal efforts made to reduce the size of the residual tumor to less than 2 cm at the primary surgery followed by "high dose" CAP therapy. The 3 year and 5 year survival rate of each group were as follows: Group A 15.6%, 15.6%, Group B 25.0%, 0%, Group C 81.8%, 0% and Group D 50.8%, 38.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)