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Comment
. 2023 Aug;49(8):1489-1494.
doi: 10.1016/j.ejso.2023.03.214. Epub 2023 Apr 13.

Peritoneal metastasis of advanced epithelial ovarian carcinoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A retrospective international multicentric data analysis

Bahar Canbay Torun  1 , Olivier Glehen  2 , Vahan Kepenekian  3 , Armando Sardi  4 , Alvaro Arjona-Sanchez  5 , Yutaka Yonemura  6 , Shoma Barat  7 , David Morris  8 , John Spiliotis  9 , Federico Coccolini  10 , Antonio Sommariva  11 , Adrian Bartos  12 , Sayyed Raza  13 , Kurt Vander Speteen  14 , Levhi Akin  15 , Tulay Irez  16 , Emel Canbay  17 ; Multicenter International PMOC Group of PSOGI
Collaborators, Affiliations
Comment

Peritoneal metastasis of advanced epithelial ovarian carcinoma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A retrospective international multicentric data analysis

Bahar Canbay Torun et al. Eur J Surg Oncol. 2023 Aug.

Abstract

Introduction: The purpose of our study was to evaluate outcome data after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastasis originating from advanced epithelial ovarian carcinoma (PMOC).

Patients and methods: A retrospective international multi-institutional registry was established through collaborative efforts of participating units affiliated with the Peritoneal Surface Oncology Group.

Results: One thousand four hundred and ninety-one patients from 11 specialized units underwent CRS and HIPEC that of those 326 (21.9%) upfront surgeries, 504 (33.8%) interval surgery, and 661(44.3%) recurrent cases. Complete Cytoreduction(CC0/1) was achieved in 1213 patients (81.3%). Treatment -related mortality was 0.8%, major operative complications (Grades 3-5) was 25.1%. Factors associated with major operative complications include prior surgical score (PSS for recurrent cases; RC) PSS>2,p = 0.000), PCI(≤15, >15 cut-off level; p ≤ 0.000), completeness of cytoreduction (CC, p=0.000), high CA125 levels (>25 mg/dl), presence of ascites, high CRP (>5 mg/dl) levels and low albumin levels (below to 2.5 mg/dl) (p ≤ 0.05). The median survival was 58 months in upfront surgery(UFS), 60 months in interval surgery(IS), and 42 months in RC. The overall survival for five years was 45% for UFS, 37% for IS, 28% for RC cases. CCscore (p = 0.000), CA125, CRP and albumin levels (p ≤ 0.05) were predictors for progression free survival. PCI(p ≤ 0.000), major postoperative complications (p = 0.004), incomplete CRS(CC2/3)(p < 0.001), prior chemotherapy (hazard ratio [HR], 3-8; p < 0.001) and PSS>2 for RC were independent predictors of poor overall survival.

Conclusion: The combined treatment strategy for PMOC may be performed safely with acceptable morbidity and mortality in the specialized units.

Keywords: Advanced epithelial ovarian carcinoma; Cytoreductive surgery; Peritoneal metastasis; hipec.

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Conflict of interest statement

Declaration of competing interest The all authors declare that we do not have any conflict of interest.

Comment on

  • Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer.
    van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, de Hingh IHJT, van der Velden J, Arts HJ, Massuger LFAG, Aalbers AGJ, Verwaal VJ, Kieffer JM, Van de Vijver KK, van Tinteren H, Aaronson NK, Sonke GS. van Driel WJ, et al. N Engl J Med. 2018 Jan 18;378(3):230-240. doi: 10.1056/NEJMoa1708618. N Engl J Med. 2018. PMID: 29342393 Clinical Trial.

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