Clinical Investigation on Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy on Patients with Peritoneal Carcinomatosis from Epithelial Ovarian Cancer

Objective To evaluate the efficacy and safety of cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) on patients with peritoneal carcinomatosis (PC) from advanced/ recurrent epithelial ovarian cancer (EOC). Methods We included 46 patients with advanced EOC (FIGO stage Ⅲc/Ⅳ, n=16, Group A) and recurrent EOC with PC (n=30, Group B) treated by CRS+HIPEC procedures. The primary endpoint was overall survival (OS) from the first treatment to disease-related death. The secondary endpoints were safety profiles. Results The median OS was 74.0 months (95%CI: 8.5-139.5) in Group A vs. 57.5 months (95%CI: 29.8-85.2) in Group B (P=0.68). The median OS for patients with PCI≤20 vs. PCI>20 were 76.6 months (95%CI: 56.5-96.7) vs. 38.5 months (95%CI: 24.2-52.8) (P=0.01). The median OS for patients with CC0-1 vs. CC2-3 were 79.5 months (95%CI: 64.8-94.2) vs. 24.3 months (95%CI: 13.9-34.7) (P=0.00). In the recurrent group, the median OS were 65.3 months (95%CI: 42.6-88.9) for platinum-sensitive patients vs. 20.0 months (95%CI: 14.5-23.5) for platinum resistant patients (P=0.05). There was no perioperative death. Postoperative adverse events occurred in five patients. Multivariate analysis revealed that CC0-1 and chemotherapy ≥ six cycles were the independent factors for OS improvement. Conclusion For patients with PC from advanced/recurrent EOC, CRS plus HIPEC could improve the OS with acceptable safety profiles, particularly for advanced EOC PC patients.