Amira Gamal, Morsi Ahmed, Fayek Ihab Samy, Mansour Osman, Nader Heba
Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt. Email:
Asian Pac J Cancer Prev. 2019 Feb 26;20(2):621-627. doi: 10.31557/APJCP.2019.20.2.621.
Objectives: To assess the efficacy of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in recurrent platinum-sensitive ovarian cancer patients in comparison with standard intravenous chemotherapy in terms of progression free survival and overall survival. Methods: Retrospective case control study matching 15 cases with 20 controls with at least 24 months of follow up. Results: The two groups were comparable and well matched in all aspects. Median follow up was 36 months in cases and 38 months in controls. The PFS2 revealed a median of 6 months (range 2-14) in cases and 5 months (range 2-18) in controls. The median OS was 36 and 38 months in cases and controls respectively. No statistically significant difference between the cases and controls were observed in progression free survival (PFS2) and overall survival OS (P-value, 0.350 and 0.711 respectively). However, the PFS2 was in favor of cases and OS was in favor of controls without reaching significance. The percentage of patients who survived 5 years or more was 20% in cases and 35% in controls. The only issue in favor of HIPEC is the significant reduction in chemotherapeutic toxicity when given by the intraperitoneal way (P- value 0.003). Conclusion: According to our study, CRS and HIPEC do not seem to have impact on OS and PFS in the setting of recurrent platinum sensitive ovarian cancer. However, we recommend on going researches with much more refined selection criteria and with larger sample size.
评估减瘤手术(CRS)联合腹腔热灌注化疗(HIPEC)与标准静脉化疗相比,对铂敏感复发性卵巢癌患者无进展生存期和总生存期的疗效。方法:回顾性病例对照研究,匹配15例病例与20例对照,随访至少24个月。结果:两组在各方面具有可比性且匹配良好。病例组中位随访时间为36个月,对照组为38个月。病例组PFS2中位数为6个月(范围2 - 14个月),对照组为5个月(范围2 - 18个月)。病例组和对照组的中位总生存期分别为36个月和38个月。病例组与对照组在无进展生存期(PFS2)和总生存期(OS)方面未观察到统计学显著差异(P值分别为0.350和0.711)。然而,PFS2倾向于病例组,OS倾向于对照组,但未达到显著水平。存活5年或更长时间的患者比例在病例组为20%,对照组为35%。支持HIPEC的唯一问题是腹腔给药时化疗毒性显著降低(P值0.003)。结论:根据我们的研究,在铂敏感复发性卵巢癌的情况下,CRS和HIPEC似乎对OS和PFS没有影响。然而,我们建议进行更严格选择标准和更大样本量的进一步研究。