Minareci Yagmur, Tosun Ozgur Aydın, Sozen Hamdullah, Topuz Samet, Salihoglu Mehmet Yavuz
Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, Istanbul, Turkey.
Istanbul University, Faculty of Medicine, Department of Gynecology and Obstetrics, Division of Gynecologic Oncology, İstanbul, Turkey.
Medeni Med J. 2020;35(3):202-211. doi: 10.5222/MMJ.2020.31855. Epub 2020 Sep 30.
The aim of this study was to reveal the results of hyperthermic intraperitoneal chemotherapy (HIPEC procedure) performed during cytoreductive surgery (CRS) in patients with endometrial cancer and epithelial ovarian cancer which included mainly platinum-resistant patients.
Patients who underwent CRS+HIPEC between May 2015 and January 2020 were evaluated retrospectively. Surgical complications were graded according to the Clavien-Dindo classification.
A total of 33 CRS+HIPEC procedures were performed in 32 patients, two of whom had recurrent endometrial cancer. Of the 30 patients with epithelial ovarian cancer (EOC), five underwent interval CRS+HIPEC, and remaining 25 patients underwent secondary CRS+HIPEC treatment due to relapsed disease. Eighteen of the patients with relapsed disease were platinum-resistant. The overall operative mortality and severe morbidity rates were %3 and 12%, respectively. For 30 patients with EOC, during a median follow-up period of 15 months, Kaplan-Meier survival analysis revealed a 1-year OS and PFS rates of 69.7% and 30.3%, respectively. Moreover, in the subgroup analysis of the platinum-resistant cohort, median OS and PFS were 14 and five months, respectively.
CRS+HIPEC procedures had acceptable severe morbidity and mortality rates. In addition, patients with recurrent EOC and without a visible residual disease at the end of cytoreductive surgery had, though not statistically significant, longer OS . HIPEC administration during CRS was not associated with adverse outcomes in the platinum-resistant EOC cohort. The short-term results of the current study are promising.
本研究旨在揭示在子宫内膜癌和上皮性卵巢癌患者的肿瘤细胞减灭术（CRS）期间进行的热灌注腹腔化疗（HIPEC手术）的结果，这些患者主要包括铂耐药患者。
对2015年5月至2020年1月期间接受CRS+HIPEC的患者进行回顾性评估。手术并发症根据Clavien-Dindo分类进行分级。
32例患者共进行了33次CRS+HIPEC手术，其中2例为复发性子宫内膜癌。在30例上皮性卵巢癌（EOC）患者中，5例接受了间隔期CRS+HIPEC，其余25例因疾病复发接受了二次CRS+HIPEC治疗。18例复发患者为铂耐药。总体手术死亡率和严重并发症发生率分别为3%和12%。对于30例EOC患者，在中位随访期15个月期间，Kaplan-Meier生存分析显示1年总生存率（OS）和无进展生存率（PFS）分别为69.7%和30.3%。此外，在铂耐药队列的亚组分析中，中位OS和PFS分别为14个月和5个月。
CRS+HIPEC手术的严重并发症和死亡率可接受。此外，复发性EOC且在肿瘤细胞减灭术结束时无可见残留病灶的患者，尽管无统计学意义，但总生存期较长。在CRS期间进行HIPEC给药与铂耐药EOC队列中的不良结局无关。本研究的短期结果很有前景。
