Somashekhar S P, Ramya Y, Ashwin K R, Shabber S Z, Ahuja V K, Amit R, Rohit K C
Surgical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bengaluru, India.
Medical Oncology, Manipal Comprehensive Cancer Centre, Manipal Hospital, Bengaluru, India.
Pleura Peritoneum. 2020 Aug 4;5(3):20200103. doi: 10.1515/pp-2020-0103. eCollection 2020 Sep.
Optimal cytoreductive surgery (CRS), followed by adjuvant chemotherapy, is a major predictor of oncological outcome in patients with advanced epithelial ovarian carcinoma (EOC). It is not clear if a delayed start of adjuvant chemotherapy negatively impacts on the oncological outcome.
Prospective registry study on 75 patients treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). Adjuvant chemotherapy was started within 42 days in 41 patients (55%), later on in 34 patients (45%). Multivariate analyses of preoperative factors were done on survival outcome. Outcomes were recurrence-free survival (RFS) and overall survival (OS).
There was no difference in RFS after early introduction (median 35 months) vs. late introduction of chemotherapy (median 32 months), p = 0.17. Median OS in patients with late introduction of chemotherapy was 46 months and was not yet reached in early introduction group.
In this exploratory study in a small group of women with advanced EOC, starting adjuvant chemotherapy more than 6 weeks after CRS and HIPEC did not deteriorate significantly RFS or OS. Well-designed clinical studies are still needed to evaluate the interplay of HIPEC and the point of time of postoperative adjuvant chemotherapy in this indication.
对于晚期上皮性卵巢癌（EOC）患者，最佳细胞减灭术（CRS）联合辅助化疗是肿瘤学预后的主要预测指标。辅助化疗延迟开始是否会对肿瘤学预后产生负面影响尚不清楚。
对75例行CRS和热灌注化疗（HIPEC）的患者进行前瞻性登记研究。41例患者（55%）在42天内开始辅助化疗，34例患者（45%）随后开始。对术前因素进行多变量生存结局分析。结局指标为无复发生存期（RFS）和总生存期（OS）。
早期开始化疗（中位35个月）与晚期开始化疗（中位32个月）后的RFS无差异，p = 0.17。晚期开始化疗患者的中位OS为46个月，早期开始化疗组尚未达到。
在这项针对一小群晚期EOC女性的探索性研究中，CRS和HIPEC后超过6周开始辅助化疗并未显著恶化RFS或OS。仍需要设计良好的临床研究来评估该适应症中HIPEC与术后辅助化疗时间点之间的相互作用。
