Cytoreductive Surgery and Intraperitoneal Chemotherapy in Advanced Serous Epithelial Ovarian Cancer: A 14-Year French Retrospective Single-Center Study of 124 Patients

Introduction Ovarian cancer (OC) is the most lethal gynecological cancer. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy appears to increase survival, and normothermic intraperitoneal chemotherapy (IPC) could improve overall survival (OS). Furthermore, intraperit...

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Vydáno v:Annals of Surgical Oncology Ročník 29; číslo 5; s. 3322 - 3334
Hlavní autoři: Paquette, Brice, Kalbacher, Elsa, Mercier, Frédéric, Lakkis, Zaher, Doussot, Alexandre, Turco, Célia, Caputo, Edda, Pili-Floury, Sébastien, Royer, Bernard, Mansi, Laura, Delroeux, Delphine, Demarchi, Martin, Pivot, Xavier, Chauffert, Bruno, Clement, Elise, Heyd, Bruno
Médium: Journal Article
Jazyk:angličtina
Vydáno: Cham Springer Science and Business Media LLC 01.05.2022
Springer International Publishing
Springer Nature B.V
Témata:
Antineoplastic Combined Chemotherapy Protocols
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Ovarian Epithelial
Carcinoma, Ovarian Epithelial - drug therapy
Carcinoma, Ovarian Epithelial - secondary
Chemotherapy
Combined Modality Therapy
Complications
Cystadenocarcinoma, Serous
Cystadenocarcinoma, Serous - drug therapy
Cystadenocarcinoma, Serous - surgery
Cytoreduction Surgical Procedures
Cytoreduction Surgical Procedures - adverse effects
Epinephrine
Gastric cancer
Gynecological cancer
Humans
Hyperthermia, Induced
Lymph nodes
Lymphatic system
Medical prognosis
Medicine
Medicine & Public Health
Metastases
Morbidity
Mortality
Multivariate analysis
Oncology
Ovarian cancer
Ovarian Neoplasms
Ovarian Neoplasms - drug therapy
Patients
Peritoneal Neoplasms
Peritoneal Neoplasms - drug therapy
Peritoneal Neoplasms - pathology
Peritoneal Surface Malignancy
Peritoneum
Postoperative
Prospective Studies
Retrospective Studies
Risk factors
Surgery
Surgical Oncology
Survival
Survival Rate
Toxicity
ISSN:1068-9265, 1534-4681, 1534-4681
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Shrnutí:Introduction Ovarian cancer (OC) is the most lethal gynecological cancer. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy appears to increase survival, and normothermic intraperitoneal chemotherapy (IPC) could improve overall survival (OS). Furthermore, intraperitoneal epinephrine could decrease the toxicity of chemotherapy by decreasing the systemic absorption of chemotherapy. The goal of this study was to assess the effects of CRS and IPC with intraperitoneal epinephrine, as first-line therapy, on the survival of patients with serous epithelial OC (EOC) with peritoneal metastases. Methods A prospective monocentric database was retrospectively searched for all patients with advanced serous EOC treated by interval or consolidative CRS plus IPC with intraperitoneal epinephrine after neoadjuvant chemotherapy. OS and disease-free survival (DFS), postoperative complications, and prognostic factors were analyzed. Results From January 2003 to December 2017, 124 patients with serous EOC were treated with interval ( n = 58) or consolidative ( n = 66) complete CRS plus IPC with intraperitoneal epinephrine. The median follow-up was 77.8 months, the median OS was 60.8 months, and the median DFS was 21.2 months. In our multivariate analysis, a higher Peritoneal Cancer Index (PCI) and positive lymph node status resulted in worse OS, while higher World Health Organization score, higher PCI score, and positive lymph node status were risk factors for worse DFS. Grade 3 or higher surgical morbidity occurred in 27.42% of cases; only 3.2% had grade 3 renal toxicity and mortality was 0.8%. Conclusion CRS and IPC with intraperitoneal epinephrine in stage III EOC offer good OS and DFS with acceptable morbidity and mortality rates.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1068-9265
1534-4681
1534-4681
DOI:10.1245/s10434-021-11211-7