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Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases

PURPOSE: The aim of this study was to help with the process of selecting patients with advanced ovarian cancer to undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) by analyzing outcome data at distinct clinical time points reflecting the natural history of th...

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Autores principales: Di Giorgio, Angelo, De Iaco, Pierandrea, De Simone, Michele, Garofalo, Alfredo, Scambia, Giovanni, Pinna, Antonio Daniele, Verdecchia, Giorgio Maria, Ansaloni, Luca, Macrì, Antonio, Cappellini, Paolo, Ceriani, Valerio, Giorda, Giorgio, Biacchi, Daniele, Vaira, Marco, Valle, Mario, Sammartino, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339330/
https://www.ncbi.nlm.nih.gov/pubmed/27896512
http://dx.doi.org/10.1245/s10434-016-5686-1
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author Di Giorgio, Angelo
De Iaco, Pierandrea
De Simone, Michele
Garofalo, Alfredo
Scambia, Giovanni
Pinna, Antonio Daniele
Verdecchia, Giorgio Maria
Ansaloni, Luca
Macrì, Antonio
Cappellini, Paolo
Ceriani, Valerio
Giorda, Giorgio
Biacchi, Daniele
Vaira, Marco
Valle, Mario
Sammartino, Paolo
author_facet Di Giorgio, Angelo
De Iaco, Pierandrea
De Simone, Michele
Garofalo, Alfredo
Scambia, Giovanni
Pinna, Antonio Daniele
Verdecchia, Giorgio Maria
Ansaloni, Luca
Macrì, Antonio
Cappellini, Paolo
Ceriani, Valerio
Giorda, Giorgio
Biacchi, Daniele
Vaira, Marco
Valle, Mario
Sammartino, Paolo
author_sort Di Giorgio, Angelo
collection PubMed
description PURPOSE: The aim of this study was to help with the process of selecting patients with advanced ovarian cancer to undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) by analyzing outcome data at distinct clinical time points reflecting the natural history of the disease. METHODS: In a retrospective Italian multicenter study investigating patients with advanced ovarian cancer who underwent CRS plus HIPEC between 1998 and 2014, we analyzed data for consecutive patients at eight treatment time points: primary debulking surgery (PDS); interval debulking surgery after partial response, after no response, and after a pathologic complete response to neoadjuvant chemotherapy; first recurrence with a progression-free interval >12, <12 months, or >12 months in patients who underwent further chemotherapy before CRS and HIPEC; and patients who underwent two or more CRS procedures and chemotherapy lines before CRS and HIPEC. RESULTS: The 511 enrolled patients underwent 3373 procedures; 72.6% achieved complete cytoreduction, with an overall major morbidity of 17.4%. At a median follow-up of 53.8 months, overall survival (OS) was 54.2 months (95% confidence interval [CI] 44–58.4) and progression-free (PFS) survival was 16.6 months (95% CI 14.7–19.1). Outcome analysis in patients in whom CRS plus HIPEC was used for primary advanced cancer or recurrent ovarian cancer showed significant differences in OS and PFS according to the time points analyzed. Multivariate analysis identified completeness of CRS, Peritoneal Cancer Index, and the times when patients underwent CRS plus HIPEC as independent prognostic factors. CONCLUSIONS: This selective information on survival should help in interpreting the findings from ongoing randomized studies focusing on CRS plus HIPEC in patients with advanced ovarian cancer.
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spelling pubmed-53393302017-03-17 Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases Di Giorgio, Angelo De Iaco, Pierandrea De Simone, Michele Garofalo, Alfredo Scambia, Giovanni Pinna, Antonio Daniele Verdecchia, Giorgio Maria Ansaloni, Luca Macrì, Antonio Cappellini, Paolo Ceriani, Valerio Giorda, Giorgio Biacchi, Daniele Vaira, Marco Valle, Mario Sammartino, Paolo Ann Surg Oncol Gynecologic Oncology PURPOSE: The aim of this study was to help with the process of selecting patients with advanced ovarian cancer to undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) by analyzing outcome data at distinct clinical time points reflecting the natural history of the disease. METHODS: In a retrospective Italian multicenter study investigating patients with advanced ovarian cancer who underwent CRS plus HIPEC between 1998 and 2014, we analyzed data for consecutive patients at eight treatment time points: primary debulking surgery (PDS); interval debulking surgery after partial response, after no response, and after a pathologic complete response to neoadjuvant chemotherapy; first recurrence with a progression-free interval >12, <12 months, or >12 months in patients who underwent further chemotherapy before CRS and HIPEC; and patients who underwent two or more CRS procedures and chemotherapy lines before CRS and HIPEC. RESULTS: The 511 enrolled patients underwent 3373 procedures; 72.6% achieved complete cytoreduction, with an overall major morbidity of 17.4%. At a median follow-up of 53.8 months, overall survival (OS) was 54.2 months (95% confidence interval [CI] 44–58.4) and progression-free (PFS) survival was 16.6 months (95% CI 14.7–19.1). Outcome analysis in patients in whom CRS plus HIPEC was used for primary advanced cancer or recurrent ovarian cancer showed significant differences in OS and PFS according to the time points analyzed. Multivariate analysis identified completeness of CRS, Peritoneal Cancer Index, and the times when patients underwent CRS plus HIPEC as independent prognostic factors. CONCLUSIONS: This selective information on survival should help in interpreting the findings from ongoing randomized studies focusing on CRS plus HIPEC in patients with advanced ovarian cancer. Springer International Publishing 2016-11-28 2017 /pmc/articles/PMC5339330/ /pubmed/27896512 http://dx.doi.org/10.1245/s10434-016-5686-1 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Gynecologic Oncology
Di Giorgio, Angelo
De Iaco, Pierandrea
De Simone, Michele
Garofalo, Alfredo
Scambia, Giovanni
Pinna, Antonio Daniele
Verdecchia, Giorgio Maria
Ansaloni, Luca
Macrì, Antonio
Cappellini, Paolo
Ceriani, Valerio
Giorda, Giorgio
Biacchi, Daniele
Vaira, Marco
Valle, Mario
Sammartino, Paolo
Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title_full Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title_fullStr Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title_full_unstemmed Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title_short Cytoreduction (Peritonectomy Procedures) Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Advanced Ovarian Cancer: Retrospective Italian Multicenter Observational Study of 511 Cases
title_sort cytoreduction (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (hipec) in advanced ovarian cancer: retrospective italian multicenter observational study of 511 cases
topic Gynecologic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339330/
https://www.ncbi.nlm.nih.gov/pubmed/27896512
http://dx.doi.org/10.1245/s10434-016-5686-1
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