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