Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients.

Abstract

BACKGROUND:

Despite a high response rate to front-line therapy, prognosis of epithelial ovarian carcinoma (EOC) remains poor. Approaches that combine Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) have been developed recently. The purpose of this study was to assess early and long-term survival in patients treated with this strategy.

PATIENTS AND METHODS:

A retrospective cohort multicentric study from French centres was performed. All consecutive patients with advanced and recurrent EOC treated with CRS and HIPEC were included.

RESULTS:

The study included 566 patients from 13 centres who underwent 607 procedures between 1991 and 2010. There were 92 patients with advanced EOC (first-line treatment), and 474 patients with recurrent EOC. A complete cytoreductive surgery was performed in 74.9% of patients. Mortality and grades 3 to 4 morbidity rates were 0.8% and 31.3%, respectively. The median overall survivals were 35.4 months and 45.7 months for advanced and recurrent EOC, respectively. There was no significant difference in overall survival between patients with chemosensitive and with chemoresistant recurrence. Peritoneal Cancer Index (PCI) that evaluated disease extent was the strongest independent prognostic factor for overall and disease-free survival in all groups.

CONCLUSION:

For advanced and recurrent EOC, curative therapeutic approach combining optimal CRS and HIPEC should be considered as it may achieve long-term survival in patients with a severe prognosis disease, even in patients with chemoresistant disease. PCI should be used for patient's selection.

• Authors: N Bakrin, J M Bereder, E Decullier, J M Classe, S Msika, G Lorimier, K Abboud, P Meeus, G Ferron, F Quenet, F Marchal, S Gouy, P Morice, C Pomel, M Pocard, F Guyon, J Porcheron, O Glehen, FROGHI (FRench Oncologic and Gynecologic HIPEC) Group
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 39 Issue 12 Pg. 1435-43 (Dec 2013) ISSN: 1532-2157 [Electronic] England
• PMID: 24209430 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Carcinoma (drug therapy, secondary, surgery)
• Chemotherapy, Cancer, Regional Perfusion (adverse effects)
• Digestive System Fistula (etiology)
• Disease-Free Survival
• Female
• France
• Humans
• Hyperthermia, Induced
• Kaplan-Meier Estimate
• Leukopenia (chemically induced)
• Middle Aged
• Ovarian Neoplasms (pathology)
• Peritoneal Neoplasms (drug therapy, secondary, surgery)
• Postoperative Hemorrhage (etiology)
• Proportional Hazards Models
• Renal Insufficiency (etiology)
• Retrospective Studies
• Survival Rate