Pavlov M J, Kovacevic P A, Ceranic M S, Stamenkovic A B, Ivanovic A M, Kecmanovic D M
Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia.
Eur J Surg Oncol. 2009 Nov;35(11):1186-91. doi: 10.1016/j.ejso.2009.03.004. Epub 2009 Apr 8.
The present study reviews our 12-year results with cytoreductive surgery and HIPEC in patients with advanced primary and recurrent ovarian cancer.
During the period from January 1995 to December 2007, 56 patients (31 with primary and 25 with recurrent epithelial ovarian cancer) underwent cytoreductive surgery and HIPEC (Doxorubicin intra-operatively, and cisplatin next 1-5 postoperative days) at our department.
52 (92.8%) patients had no gross residual disease after the complete surgical procedure (Sugarbaker completeness of cytoreduction CC, score 0-1), and 4 patients had macroscopic residual disease (CC-2 or CC-3) Average PCI (peritoneal cancer index) was 13.4 (4-28). Mean follow-up was 56 months (range, 1-135). The median operation time was 279min (range 190 + or - 500min). Median total blood loss was 850mL (range 250 + or - 1550mL). The median survival time was 34.1 months for primary, 40.1 for recurrent ovarian cancer without statistically significance difference (p>0.05) and median disease-free survival was 26.2 months. The PCI was equal or less than 12 in 31 patients and their median survival time was statistically significant longer than median survival time of months for the 25 patients with PCI greater then 12 (p<0.01). Morbidity and mortality rate were 17.8% (10/56) and 1.8% (1/56).
This series indicates that in the majority of patients with primary and recurrent advanced ovarian cancer, cytoreductive surgery combined with HIPEC can lead to a substantial increase in subsequent rates of disease-free and overall survival.
本研究回顾了我们对晚期原发性和复发性卵巢癌患者进行细胞减灭术和腹腔热灌注化疗(HIPEC)的12年结果。
在1995年1月至2007年12月期间,56例患者(31例原发性上皮性卵巢癌和25例复发性上皮性卵巢癌)在我科接受了细胞减灭术和腹腔热灌注化疗(术中使用阿霉素,术后1 - 5天使用顺铂)。
52例(92.8%)患者在完整手术过程后无肉眼可见残留病灶(根据Sugarbaker细胞减灭完整性CC评分,评分为0 - 1),4例患者有肉眼可见残留病灶(CC - 2或CC - 3)。平均腹膜癌指数(PCI)为13.4(4 - 28)。平均随访时间为56个月(范围1 - 135个月)。中位手术时间为279分钟(范围190±500分钟)。中位总失血量为850毫升(范围250±1550毫升)。原发性卵巢癌的中位生存时间为34.1个月,复发性卵巢癌为40.1个月,无统计学显著差异(p>0.05),中位无病生存时间为26.2个月。31例患者的PCI等于或小于12,其中位生存时间在统计学上显著长于25例PCI大于12患者的中位生存时间(p<0.01)。发病率和死亡率分别为17.8%(10/56)和1.8%(1/56)。
本系列研究表明,对于大多数原发性和复发性晚期卵巢癌患者,细胞减灭术联合腹腔热灌注化疗可显著提高后续无病生存率和总生存率。