Lyu Mengmeng, Lu Jin, Shen Yang, Chen Qianqian, Deng Fei, Wang Jinhua
Department of Gynecologic Oncology, Jiangsu Cancer Hospital / Jiangsu Institute of Cancer Research / The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
Front Surg. 2022 Sep 12;9:997344. doi: 10.3389/fsurg.2022.997344. eCollection 2022.
To study the efficacy of interval debulking surgery (IDS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) compared to IDS alone for the treatment of ovarian cancer after neoadjuvant chemotherapy (NACT).
We conducted a retrospective study of patients with stage IIIC/IV high-grade serous ovarian carcinoma who underwent surgery at our center from January 2018 to December 2019. Patients who underwent IDS after NACT with ( = 20) or without ( = 42) HIPEC were included. HIPEC was administered after surgery and was combined with 1-2 courses of intraperitoneal hyperthermic perfusion with normal saline only. We analyzed clinical information and outcomes for the two groups.
The median progression-free survival (PFS) was 14.05 months in the IDS plus HIPEC group and 12.97 months in the IDS group ( = 0.597). The median overall survival (OS) was not reached. After adjustment for age between the two groups, the differences in PFS and OS remained nonsignificant. The change ratio of postoperative CA-125 to preoperative CA-125 was 0.66 in the IDS plus HIPEC group and 0.53 in the IDS group ( = 0.341). The difference in human epididymis protein 4 (HE-4) change ratio between the two groups was nonsignificant ( = 0.225). No significant difference was observed in the occurrence of grade 3 and 4 adverse events between the two groups ( = 0.201).
After NACT, IDS plus HIPEC did not show significant PFS and tumor index change ratio benefits over IDS alone in patients with primary ovarian cancer. Further investigations are needed to assess the role of HIPEC in the treatment of ovarian cancer.
研究间隔减瘤手术(IDS)联合热灌注腹腔化疗(HIPEC)与单纯IDS治疗新辅助化疗(NACT)后卵巢癌的疗效。
我们对2018年1月至2019年12月在本中心接受手术的IIIC/IV期高级别浆液性卵巢癌患者进行了一项回顾性研究。纳入在NACT后接受IDS联合(n = 20)或不联合(n = 42)HIPEC的患者。HIPEC在手术后进行,仅与1 - 2个疗程的生理盐水腹腔热灌注联合使用。我们分析了两组的临床信息和结局。
IDS联合HIPEC组的中位无进展生存期(PFS)为14.05个月,IDS组为12.97个月(P = 0.597)。中位总生存期(OS)未达到终点。两组年龄调整后,PFS和OS的差异仍无统计学意义。IDS联合HIPEC组术后CA - 125与术前CA - 125的变化率为0.66,IDS组为0.53(P = 0.341)。两组人附睾蛋白4(HE - 4)变化率的差异无统计学意义(P = 0.225)。两组3级和4级不良事件的发生率无显著差异(P = 0.201)。
对于原发性卵巢癌患者,NACT后,IDS联合HIPEC在PFS和肿瘤指标变化率方面并不比单纯IDS有显著优势。需要进一步研究来评估HIPEC在卵巢癌治疗中的作用。