Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: A French multicentre retrospective cohort study of 566 patients
Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: A French multicentre retrospective cohort study of 566 patients
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DOI：
10.1016/j.ejso.2013.09.030
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发表时间：
2013-12-01
期刊：
影响因子：
3.8
通讯作者：
Glehen, O.
中科院分区：
文献类型：
--
作者：
Bakrin, N.;Bereder, J. M.;Glehen, O.
背景：尽管一线治疗有效率很高，但上皮性卵巢癌(EOC)的预后仍然很差。细胞减灭术(CRS)和热疗(HIPEC)相结合的方法是近年来发展起来的。这项研究的目的是评估接受该策略治疗的患者的早期和长期存活率。患者和方法：从法国中心进行了一项多中心的回顾性队列研究。所有连续接受CRS和HIPEC治疗的晚期和复发上皮性卵巢癌患者纳入研究。结果：这项研究包括来自13个中心的566名患者，在1991-2010年间共接受了607次手术。92例为一线治疗的晚期卵巢癌患者，474例为复发性卵巢癌患者。74.9%的患者完成了完整的细胞减少术。死亡率和3~4级发病率分别为0.8%和31.3%。晚期和复发EoC患者的中位总生存期分别为35.4个月和45.7个月。化疗敏感和化疗耐药复发患者的总存活率无显著差异。结论：对于晚期和复发的卵巢癌患者，应考虑最佳CRS和HIPEC相结合的治疗方法，因为对于预后严重的患者，即使是化疗耐药的患者，也可以获得长期的生存。患者应选择经皮冠状动脉介入治疗。(C)2013爱思唯尔有限公司。保留所有权利。
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. (C) 2013 Elsevier Ltd. All rights reserved.