Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC).

IF 1.6 Q4 ONCOLOGY
International Journal of Surgical Oncology Pub Date : 2020-12-16 eCollection Date: 2020-01-01 DOI:10.1155/2020/1467403
Carlos A Munoz-Zuluaga, Armando Sardi, Michelle Sittig, Vadim Gushchin, Mary C King, Carol Nieroda, Felipe Lopez-Ramirez, Teresa P Diaz-Montes
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引用次数: 2

Abstract

Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) after neoadjuvant chemotherapy (NACT) showed promise as initial treatment for stage IIIC (SIII) epithelial ovarian cancer (EOC); however, stage IV (SIV) outcomes are rarely reported. We assessed our experience and outcomes treating newly diagnosed SIV EOC with NACT plus CRS/HIPEC compared to SIII patients.

Methods: Advanced EOC from 2015-2018 managed with NACT (carboplatin/paclitaxel) due to unresectable disease or poor performance status followed by interval CRS/HIPEC were reviewed. Perioperative factors were assessed. Overall survival (OS) and progression-free survival (PFS) were analyzed by stage.

Results: Twenty-seven FIGO stage IIIC (n = 12) and IV (n = 15) patients were reviewed. Median NACT cycles were 3 and 4, respectively. Post-NACT omental caking, ascites, and pleural effusions decreased/resolved in 91%, 91%, and 100% of SIII and 85%, 92%, and 71% of SIV. SIII/SIV median PCI was 21 and 20 obtaining 92% and 100% complete cytoreduction (≤0.25 cm), respectively. Median organ resections were 6 and 7, respectively. Grade III/IV surgical complications were 0% SIII and 23% SIV, without hospital mortality. Median time to adjuvant chemotherapy was 53 and 74 days, respectively (p=0.007). SIII OS at 1 and 2 years was 100% and 83% and 87% and 76% in SIV (p=0.269). SIII 1-year PFS was 54%; median PFS: 12 months. SIV 1- and 2- year PFS was 47% and 23%; median PFS: 12 months (p=0.944).

Conclusion: Outcomes in select initially diagnosed and unresectable SIV EOC are similar to SIII after NACT plus CRS/HIPEC. SIV EOC may benefit from CRS/HIPEC, and further studies should explore this treatment approach.

Abstract Image

Abstract Image

IV期上皮性卵巢癌患者接受新辅助化疗后细胞减少手术和腹腔热化疗(CRS/HIPEC)的关键分析。
背景:新辅助化疗(NACT)后的细胞减少手术和腹腔内高温化疗(CRS/HIPEC)有望成为IIIC期(SIII)上皮性卵巢癌(EOC)的初始治疗方法;然而,IV期(SIV)的结果很少被报道。我们评估了与SIII患者相比,NACT + CRS/HIPEC治疗新诊断的SIV EOC的经验和结果。方法:回顾2015-2018年因疾病不可切除或表现不佳而采用NACT(卡铂/紫杉醇)治疗的晚期EOC,并随访CRS/HIPEC。评估围手术期因素。分阶段分析总生存期(OS)和无进展生存期(PFS)。结果:回顾了27例FIGO IIIC期(n = 12)和IV期(n = 15)患者。中位NACT周期分别为3和4。nact后,SIII患者的91%、91%和100%以及SIV患者的85%、92%和71%的网膜结块、腹水和胸腔积液减少/消除。SIII/SIV中位PCI分别为21和20,分别获得92%和100%的完全细胞减少(≤0.25 cm)。中位器官切除分别为6例和7例。III/IV级手术并发症为0% SIII和23% SIV,无住院死亡率。辅助化疗的中位时间分别为53天和74天(p=0.007)。SIII的1年和2年OS分别为100%和83%,SIV的87%和76% (p=0.269)。SIII 1年PFS为54%;中位PFS: 12个月。SIV 1年和2年PFS分别为47%和23%;中位PFS: 12个月(p=0.944)。结论:选择最初诊断和不可切除的SIV EOC的结果与NACT + CRS/HIPEC后的SIV EOC相似。SIV EOC可能受益于CRS/HIPEC,进一步的研究应该探索这种治疗方法。
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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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