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Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRSHIPEC)
Joint Authors
Gushchin, Vadim
Sardi, Armando
Munoz-Zuluaga, Carlos A.
Sittig, Michelle
King, Mary C.
Nieroda, Carol
Lopez-Ramirez, Felipe
Diaz-Montes, Teresa P.
Source
International Journal of Surgical Oncology
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-14, 14 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-12-17
Country of Publication
Egypt
No. of Pages
14
Main Subjects
Abstract EN
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.
American Psychological Association (APA)
Munoz-Zuluaga, Carlos A.& Sardi, Armando& Sittig, Michelle& Gushchin, Vadim& King, Mary C.& Nieroda, Carol…[et al.]. 2020. Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRSHIPEC). International Journal of Surgical Oncology،Vol. 2020, no. 2020, pp.1-14.
https://search.emarefa.net/detail/BIM-1174153
Modern Language Association (MLA)
Munoz-Zuluaga, Carlos A.…[et al.]. Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRSHIPEC). International Journal of Surgical Oncology No. 2020 (2020), pp.1-14.
https://search.emarefa.net/detail/BIM-1174153
American Medical Association (AMA)
Munoz-Zuluaga, Carlos A.& Sardi, Armando& Sittig, Michelle& Gushchin, Vadim& King, Mary C.& Nieroda, Carol…[et al.]. Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRSHIPEC). International Journal of Surgical Oncology. 2020. Vol. 2020, no. 2020, pp.1-14.
https://search.emarefa.net/detail/BIM-1174153
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1174153