Lee Yong Jae, Seon Ki Eun, Jung Dae Chul, Lee Jung-Yun, Nam Eun Ji, Kim Sang Wun, Kim Sunghoon, Kim Young Tae
Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
Department of Radiology, Yonsei Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
Front Oncol. 2022 Jul 28;12:936099. doi: 10.3389/fonc.2022.936099. eCollection 2022.
To evaluate the additive effects of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval debulking surgery (IDS) in patients with advanced-stage ovarian cancer. From January 2015 to February 2019, 123 patients with stages IIIC-IV ovarian cancer were treated with neoadjuvant chemotherapy (NAC) followed by IDS with optimal cytoreduction. Forty-three patients received IDS with HIPEC and 80 patients had IDS without HIPEC. The median follow-up period was 34.4 months. No differences in baseline characteristics in patients were found between the two groups. The IDS with HIPEC group had fewer median cycles of chemotherapy ( = 0.002) than the IDS group. The IDS with HIPEC group had a higher rate of high surgical complexity score ( = 0.032) and higher rate of complete resection ( = 0.041) compared to the IDS group. The times to start adjuvant chemotherapy were longer in the IDS with HIPEC group compared to the IDS group ( < 0.001). Postoperative grade 3 or 4 complications were similar in the two groups ( = 0.237). Kaplan-Meier analysis showed that HIPEC with the IDS group had better progression-free survival (PFS) ( = 0.010), while there was no difference in overall survival between the two groups ( = 0.142). In the multivariate analysis, HIPEC was significantly associated with better PFS (HR, 0.60; 95% CI, 0.39 - 0.93). The addition of HIPEC to IDS resulted in longer PFS than IDS without HIPEC not affecting the safety profile. Further research is needed to evaluate the true place of HIPEC in the era of targeted treatments.
评估热灌注腹腔化疗（HIPEC）对晚期卵巢癌患者间歇性肿瘤细胞减灭术（IDS）的附加效果。2015年1月至2019年2月，123例IIIC-IV期卵巢癌患者接受了新辅助化疗（NAC），随后进行了具有最佳细胞减灭效果的IDS。43例患者接受了IDS联合HIPEC治疗，80例患者接受了单纯IDS治疗。中位随访期为34.4个月。两组患者的基线特征无差异。与单纯IDS组相比，IDS联合HIPEC组的化疗中位周期数更少（P = 0.002）。与单纯IDS组相比，IDS联合HIPEC组的手术复杂程度高分率更高（P = 0.032），完全切除率更高（P = 0.041）。与单纯IDS组相比，IDS联合HIPEC组开始辅助化疗的时间更长（P < 0.001）。两组术后3级或4级并发症相似（P = 0.237）。Kaplan-Meier分析显示，IDS联合HIPEC组的无进展生存期（PFS）更好（P = 0.010），而两组的总生存期无差异（P = 0.142）。在多变量分析中，HIPEC与更好的PFS显著相关（风险比，0.60；95%置信区间，0.39 - 0.93）。IDS联合HIPEC比单纯IDS能带来更长的PFS，且不影响安全性。需要进一步研究来评估HIPEC在靶向治疗时代的真正地位。
