Petrillo M, De Iaco P, Cianci S, Perrone M, Costantini B, Ronsini C, Scambia G, Fagotti A
Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, S. Orsola Hospital, University of Bologna, Bologna, Italy.
Ann Surg Oncol. 2016 May;23(5):1660-5. doi: 10.1245/s10434-015-5050-x. Epub 2015 Dec 29.
To analyze the 5- and 7-year survival outcomes for women with platinum-sensitive recurrent epithelial ovarian cancer (REOC) who underwent secondary cytoreductive surgery (SCS) plus platinum-based hyperthermic intraperitoneal chemotherapy (HIPEC).
From the electronic databases of the Department of Obstetrics and Gynecology at the Catholic University of the Sacred Heart of Rome and of the S. Orsola Hospital, University of Bologna, a consecutive series of REOC patients were selected using the following inclusion criteria: primary platinum-free interval (PFI-1) of 6 months or longer, completeness of secondary cytoreduction score (CC) of 1 or lower, minimum follow-up period of 48 months, Eastern Cooperative Group (ECOG) performance status at recurrence of 1 or less, and platinum-based HIPEC. Progression-free survival (PFS) and post-relapse survival (PRS) were calculated as the time between SCS + HIPEC and secondary recurrence or death, respectively.
The final study population included 70 women with platinum-sensitive REOC. The median follow-up time was 73 months (range 48-128 months), and the median PFI-1 was 19 months (range 6-100 months). At the time of recurrence, the median peritoneal cancer index was 7 (range 1-21), and a CC score of 0 was achieved for 62 patients (88.6 %). As the HIPEC drug, we used oxaliplatin in 17 cases (38.6 %) and cisplatin in 43 cases (61.4 %). No postoperative deaths were observed, and the complication rate for grades 3 and 4 disease was 8.6 %. The median PFS duration was 27 months (range 5-104 months), and the 5- and 7-year PRS rates were respectively 52.8 and 44.7 %, (median PRS 63 months).
The current study demonstrated favorable 5- and 7-year PRS rates for platinum-sensitive REOC patients undergoing SCS + HIPEC, which encourages the inclusion of patients in randomized clinical trials for definitive conclusions to be drawn.
分析接受二次细胞减灭术（SCS）加铂类腹腔热灌注化疗（HIPEC）的铂敏感复发性上皮性卵巢癌（REOC）女性患者的5年和7年生存结局。
从罗马圣心天主教大学妇产科以及博洛尼亚大学圣奥索拉医院的电子数据库中，根据以下纳入标准选取一系列连续性的REOC患者：初次铂类无治疗间隔期（PFI-1）为6个月或更长，二次细胞减灭术评分（CC）为1或更低，最短随访期为48个月，复发时东部肿瘤协作组（ECOG）体能状态为1或更低，以及采用铂类HIPEC。无进展生存期（PFS）和复发后生存期（PRS）分别计算为SCS+HIPEC与二次复发或死亡之间的时间。
最终研究人群包括70例铂敏感REOC女性患者。中位随访时间为73个月（范围48-128个月），中位PFI-1为19个月（范围6-100个月）。复发时，中位腹膜癌指数为7（范围1-21），62例患者（88.6%）达到CC评分为0。作为HIPEC药物，17例（38.6%）使用奥沙利铂，43例（61.4%）使用顺铂。未观察到术后死亡，3级和4级疾病的并发症发生率为8.6%。中位PFS持续时间为27个月（范围5-104个月），5年和7年PRS率分别为52.8%和44.7%（中位PRS 63个月）。
本研究表明，接受SCS+HIPEC的铂敏感REOC患者5年和7年PRS率良好，这鼓励将患者纳入随机临床试验以得出明确结论。
