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联合间歇性细胞减灭术和卡铂为基础的腹腔热灌注化疗治疗晚期原发性高级别浆液性卵巢癌。

Combined Interval Cytoreductive Surgery and Carboplatin-Based Hyperthermic Intraperitoneal Chemotherapy in Advanced Primary High-Grade Serous Ovarian Cancer.

机构信息

Department of Obstetrics and Gynecology, University of Montreal, Montreal, QC H3T 1J4, Canada.

Department of Surgery, CHU de Québec-Université Laval, Quebec, QC G1V 4G2, Canada.

出版信息

Curr Oncol. 2023 Dec 1;30(12):10272-10282. doi: 10.3390/curroncol30120748.

Abstract

Combining interval cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in advanced epithelial ovarian carcinoma (EOC). Although limited, growing evidence regarding carboplatin-based HIPEC highlights its potential. This retrospective study included all patients with advanced primary high-grade serous ovarian cancer who underwent interval CRS combined with carboplatin-based HIPEC at our Canadian tertiary care center between 2014 and 2020. We identified 40 patients with a median age of 61 years. The median peritoneal cancer index was 13 and complete cytoreduction was achieved in 38 patients (95%). Median hospital stay was 13 days and there were four admissions to the intensive care unit (10%) and six readmissions (15%). Severe adverse events occurred in eight patients (20%) and there was no perioperative death. Recurrence was seen in 33 patients (82%) with a median DFS of 18.0 months and a median overall survival of 36.4 months. Multivariate analyses showed that age, peritoneal cancer index, completeness of cytoreduction, occurrence of severe complications, and bowel resection did not significantly impact DFS or OS in our cohort. Interval CRS combined with carboplatin-based HIPEC for advanced primary EOC is associated with acceptable morbidity and oncological outcomes. Larger studies are required to determine the long-term outcomes.

摘要

在晚期上皮性卵巢癌(EOC)中,联合间隔细胞减灭术(CRS)和腹腔内热灌注化疗(HIPEC)可提高生存率。尽管证据有限,但越来越多的关于基于卡铂的 HIPEC 的证据突显了其潜力。本回顾性研究纳入了 2014 年至 2020 年间在我们加拿大三级护理中心接受间隔 CRS 联合基于卡铂的 HIPEC 治疗的所有晚期原发性高级别浆液性卵巢癌患者。我们确定了 40 名中位年龄为 61 岁的患者。中位腹膜癌指数为 13,38 名患者(95%)达到完全肿瘤减灭。中位住院时间为 13 天,有 4 名患者(10%)入住重症监护病房,6 名患者(15%)再次入院。8 名患者(20%)发生严重不良事件,无围手术期死亡。33 名患者(82%)出现复发,中位无进展生存期(DFS)为 18.0 个月,中位总生存期(OS)为 36.4 个月。多变量分析显示,在我们的队列中,年龄、腹膜癌指数、肿瘤细胞减灭的完全程度、严重并发症的发生和肠切除术均未显著影响 DFS 或 OS。间隔 CRS 联合基于卡铂的 HIPEC 治疗晚期原发性 EOC 与可接受的发病率和肿瘤学结果相关。需要更大规模的研究来确定长期结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b55/10742627/3c273bc08c6d/curroncol-30-00748-g001.jpg

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