Acs Miklos, Gerken Michael, Schmitt Vanessa, Piso Pompiliu, Königsrainer Alfred, Baransi Saher, Yurttas Can, Häusler Sebastian, Horvath Philipp
Department of General and Visceral Surgery, Hospital Barmherzige Brüder, 93049 Regensburg, Germany.
Tumor Center-Institute for Quality Management and Health Services Research, University of Regensburg, 93049 Regensburg, Germany.
Cancers (Basel). 2023 Jan 7;15(2):405. doi: 10.3390/cancers15020405.
This bicentric study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for platinum-sensitive recurrent ovarian cancer patients.
The data of 88 patients with the first peritoneal recurrence of platinum-sensitive epithelial ovarian cancer who underwent CRS and HIPEC from a prospective HIPEC registry were retrospectively investigated. Endpoints were feasibility, chemotherapeutic compound, time of exposure, complications, and overall survival.
The median follow-up was 4.7 years (95%-CI 4.6-5.5). The median age was 55.8 years (IQR: 50.3-66.2). Eighty-four patients (95.5%) had high-grade serous histology. The median peritoneal cancer index was 12.0 (IQR: 7.0-20.5). Sixty-five patients (73.9%) had complete cytoreduction (CCR 0). Thirty-eight patients (43.2%) received HIPEC for 60 min, and fifty patients (56.8%) for 90 min. Eighteen patients (20.5%) had grade III to IV complications. One patient (1.1%) died perioperatively. The overall median survival was 43.1 months (95%-CI 34.1-52.2), and the 5-year survival rate was 39.7%. Only 90 min HIPEC and cisplatin were associated with survival.
In well-selected patients with platinum-sensitive recurrent ovarian cancer, survival may correlate with complete CRS and 90 min cisplatin-based HIPEC. We confirmed the results of primary OC studies; therefore, this combination should be used for further analysis in the recurrent situation.
本双中心研究评估了减瘤手术（CRS）联合腹腔热灌注化疗（HIPEC）用于铂敏感复发性卵巢癌患者的疗效。
回顾性调查了88例来自前瞻性HIPEC登记处的铂敏感上皮性卵巢癌首次腹膜复发且接受CRS和HIPEC治疗患者的数据。观察指标包括可行性、化疗药物、暴露时间、并发症及总生存期。
中位随访时间为4.7年（95%可信区间4.6 - 5.5）。中位年龄为55.8岁（四分位间距：50.3 - 66.2）。84例患者（95.5%）为高级别浆液性组织学类型。中位腹膜癌指数为12.0（四分位间距：7.0 - 20.5）。65例患者（73.9%）实现了完全减瘤（CCR 0）。38例患者（43.2%）接受了60分钟的HIPEC治疗，50例患者（56.8%）接受了90分钟的HIPEC治疗。18例患者（20.5%）出现Ⅲ至Ⅳ级并发症。1例患者（1.1%）围手术期死亡。总中位生存期为43.1个月（95%可信区间34.1 - 52.2），5年生存率为39.7%。仅90分钟的HIPEC治疗和顺铂与生存期相关。
在精心挑选的铂敏感复发性卵巢癌患者中，生存期可能与完全CRS及90分钟基于顺铂的HIPEC治疗相关。我们证实了原发性卵巢癌研究的结果；因此，这种联合治疗应在复发性情况下用于进一步分析。
