a Unit of Oncologic and Pancreatic Surgery , University Hospital Reina Sofia , Cordoba , Spain.
b CIBERehd, IMIBIC , University Hospital Reina Sofia , Cordoba , Spain.
Int J Hyperthermia. 2017 Aug;33(5):554-561. doi: 10.1080/02656736.2017.1278631.
The treatment of advanced primary or recurrent ephitelial ovarian cancer still remains an open and a critical question. The addition of HIPEC to cytoreductive surgery has shown improving overall survival rates. The aim of our study is to describe the progress in its management in our Unit and what we have learned after more than 350 HIPEC procedures.
From 1997 to 2016 we conducted a retrospective analysis from a prospective database. We described and analyzed 4 cut-points, 1997-2004, 2009, 2012 and 2016.
From 1997 to September 2016, 358 patients have been operated in our Unit by CRS with peritonectomy procedures plus HIPEC for stage IIIc and IV ovarian cancer. The HIPEC procedures rate was 4,7 HIPEC per years in the first years up to 35 HIPEC/year in last era. Mean age was 56,7 years (28-78). Median PCI was 15,8. (range 3-36). R0-cytoreduction was 95%. Severe morbidity and mortality were observed in 15 % and 2%, respectively. The 3 y OS was 77% in primary and 79% in recurrent ovarian cancer. The stage IV was not a risk factor for survival. R1 cytoreduction and positive lymph nodes were risk factors in multivariate analysis.
The addition of HIPEC to CRS improves overall survival rates for primary and recurrent ovarian cancer. This therapeutic strategy was incorporated twenty years ago for a few teams in the world and today there is an emerging and strong evidence that could consider it as an standard treatment for the ovarian carcinomatosis.
上皮性卵巢癌的晚期或复发性肿瘤的治疗仍然是一个悬而未决的问题。细胞减灭术联合腹腔热灌注化疗（HIPEC）已显示出可提高总体生存率。本研究的目的是描述我们科室在这方面的管理进展，并在进行了超过 350 例 HIPEC 手术后，总结我们的经验教训。
从 1997 年至 2016 年，我们对一个前瞻性数据库进行了回顾性分析。我们描述和分析了 4 个时间点，分别是 1997-2004 年、2009 年、2012 年和 2016 年。
从 1997 年至 2016 年 9 月，我们科室对 358 例 IIIc 和 IV 期卵巢癌患者进行了细胞减灭术和腹膜切除术，并联合 HIPEC。在最初的几年里，每年进行 4 次 HIPEC，而在最后一个时期每年进行 35 次 HIPEC。患者的平均年龄为 56.7 岁（28-78 岁）。中位 PCI 为 15.8（范围 3-36）。达到了 95%的 R0 减瘤率。严重发病率和死亡率分别为 15%和 2%。原发性和复发性卵巢癌的 3 年 OS 分别为 77%和 79%。IV 期不是生存的危险因素。在多变量分析中，R1 减瘤率和阳性淋巴结是生存的危险因素。
细胞减灭术联合 HIPEC 可提高原发性和复发性卵巢癌的总体生存率。这种治疗策略在 20 年前被少数团队引入，如今有越来越多的有力证据表明，它可以被视为卵巢癌转移的标准治疗方法。
