Sinukumar Snita, Damodaran Dileep, Ray Mukurdipi, Prabhu Aruna, Katdare Ninad, Vikram Syam, Shaikh Sakina, Patel Ankita, Bhatt Aditi
Department of Surgical Oncology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra India.
Department of Surgical Oncology, MVR, Cancer Center and Research Institute, Calicut, Kerala India.
Indian J Surg Oncol. 2023 Jun;14(Suppl 1):74-81. doi: 10.1007/s13193-022-01640-5. Epub 2022 Sep 7.
The aim of this study was to evaluate the potential role of optimal cytoreductive surgery with or without HIPEC in the management of peritoneal dissemination from rare histological subtypes of ovarian cancer and to report the prognostic factors affecting survival. In this retrospective multicentric study, all patients with diagnosis of locally advanced ca ovary with histology other than high-grade serous carcinoma and those having undergone cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy for the same were included. Factors affecting survival were evaluated in addition to studying the clinicopathological features. In the period from January 2013 to December 2021, 101 consecutive patients of ovarian cancer with rare histology underwent cytoreductive surgery with or without HIPEC. The median OS was not reached (NR), and the median PFS was 60 months. On evaluation of factors affecting overall survival (OS) and progression-free survival (PFS), PCI > 15 was associated with not only a decreased PFS ( = 0.019) but also a decreased OS ( = 0.019) on univariate and multivariate analysis. With respect to histology, the best OS and PFS were seen with granulosa cell tumor, mucinous tumors for which median OS and median PFS were NR respectively. Cytoreductive surgery can be performed with an acceptable morbidity in patients with peritoneal dissemination from ovarian tumors of rare histology. The role of HIPEC and impact of other prognostic factors on the treatment and survival outcome need further evaluation in larger series of patients.
The online version contains supplementary material available at 10.1007/s13193-022-01640-5.
本研究的目的是评估最佳细胞减灭术联合或不联合腹腔热灌注化疗(HIPEC)在罕见组织学亚型卵巢癌腹膜播散治疗中的潜在作用,并报告影响生存的预后因素。在这项回顾性多中心研究中,纳入了所有诊断为局部晚期卵巢癌且组织学类型不是高级别浆液性癌的患者,以及那些因相同疾病接受了细胞减灭术(CRS)联合或不联合热腹腔内化疗的患者。除了研究临床病理特征外,还评估了影响生存的因素。在2013年1月至2021年12月期间,101例连续的罕见组织学类型卵巢癌患者接受了细胞减灭术联合或不联合HIPEC。中位总生存期(OS)未达到(NR),中位无进展生存期(PFS)为60个月。在评估影响总生存期(OS)和无进展生存期(PFS)的因素时,单因素和多因素分析显示,腹膜癌指数(PCI)>15不仅与PFS降低(=0.019)相关,而且与OS降低(=0.019)相关。就组织学而言,颗粒细胞瘤的OS和PFS最佳,黏液性肿瘤的中位OS和中位PFS均未达到。对于罕见组织学类型的卵巢肿瘤腹膜播散患者,细胞减灭术的并发症发生率可以接受。HIPEC的作用以及其他预后因素对治疗和生存结果的影响需要在更大规模的患者系列中进一步评估。
在线版本包含可在10.1007/s13193-022-01640-5获取的补充材料。