Peritoneal mestastases from rare ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC)

IF 1.4 Q4 ONCOLOGY Pleura and Peritoneum Pub Date : 2023-12-27 DOI:10.1515/pp-2023-0019
Luis Felipe Falla-Zuniga, A. Sardi, M. King, F. Lopez-Ramirez, Philipp Barakat, C. Nieroda, T. Diaz-Montes, V. Gushchin
{"title":"Peritoneal mestastases from rare ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC)","authors":"Luis Felipe Falla-Zuniga, A. Sardi, M. King, F. Lopez-Ramirez, Philipp Barakat, C. Nieroda, T. Diaz-Montes, V. Gushchin","doi":"10.1515/pp-2023-0019","DOIUrl":null,"url":null,"abstract":"Abstract Objective There are limited treatment options and no consensus on the management of advanced rare ovarian malignancies. Rare ovarian malignancies can present with peritoneal metastases (PM), featuring a similar presentation to more common ovarian subtypes. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an effective treatment for PM of non-gynecologic origin and, recently, epithelial ovarian cancer. We evaluated the feasibility of CRS/HIPEC in the management of PM from rare ovarian malignancies and report postoperative outcomes on these patients. Methods A retrospective review of a single center, prospective database (1994–2021) was performed to identify patients with rare ovarian malignancies treated with CRS/HIPEC. Clavien-Dindo 90-day morbidity/mortality and Kaplan–Meier overall (OS) and progression-free survival (PFS) were analyzed. Results Of 44 patients identified, 28 underwent CRS/HIPEC. Six were aborted due to extensive disease. Histologic subtypes included: clear cell (5/28, 17.9 %), endometrioid (5/28, 17.9 %), granulosa cell (3/28, 10.7 %), low-grade serous (6/28, 21.4 %), mesonephric (1/28, 3.6 %), mucinous (6/28, 21.4 %), and small cell (2/28, 7.1 %) carcinomas. Eight (28.6 %) patients had primary and 20 (71.4 %) had recurrent disease. Median peritoneal cancer index (PCI) was 21 (IQR: 6–29). Complete cytoreduction (<2.5 mm residual disease) was achieved in 27/28 (96.4 %). Grade III/IV complications occurred in 9/28 (32.1 %) with one (3.6 %) mortality. After a median follow-up of 65.8 months, 20 patients were alive. Five-year OS and PFS were 68.5 and 52.6 %, respectively. Conclusions In patients with PM from rare ovarian malignancies, CRS/HIPEC is feasible and has an acceptable safety profile. Longer follow-up and multicenter trials are needed.","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pleura and Peritoneum","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1515/pp-2023-0019","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Abstract Objective There are limited treatment options and no consensus on the management of advanced rare ovarian malignancies. Rare ovarian malignancies can present with peritoneal metastases (PM), featuring a similar presentation to more common ovarian subtypes. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an effective treatment for PM of non-gynecologic origin and, recently, epithelial ovarian cancer. We evaluated the feasibility of CRS/HIPEC in the management of PM from rare ovarian malignancies and report postoperative outcomes on these patients. Methods A retrospective review of a single center, prospective database (1994–2021) was performed to identify patients with rare ovarian malignancies treated with CRS/HIPEC. Clavien-Dindo 90-day morbidity/mortality and Kaplan–Meier overall (OS) and progression-free survival (PFS) were analyzed. Results Of 44 patients identified, 28 underwent CRS/HIPEC. Six were aborted due to extensive disease. Histologic subtypes included: clear cell (5/28, 17.9 %), endometrioid (5/28, 17.9 %), granulosa cell (3/28, 10.7 %), low-grade serous (6/28, 21.4 %), mesonephric (1/28, 3.6 %), mucinous (6/28, 21.4 %), and small cell (2/28, 7.1 %) carcinomas. Eight (28.6 %) patients had primary and 20 (71.4 %) had recurrent disease. Median peritoneal cancer index (PCI) was 21 (IQR: 6–29). Complete cytoreduction (<2.5 mm residual disease) was achieved in 27/28 (96.4 %). Grade III/IV complications occurred in 9/28 (32.1 %) with one (3.6 %) mortality. After a median follow-up of 65.8 months, 20 patients were alive. Five-year OS and PFS were 68.5 and 52.6 %, respectively. Conclusions In patients with PM from rare ovarian malignancies, CRS/HIPEC is feasible and has an acceptable safety profile. Longer follow-up and multicenter trials are needed.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
用细胞切除手术和腹腔热化疗(CRS/HIPEC)治疗罕见卵巢癌腹膜转移灶
摘要 目的 对于晚期罕见卵巢恶性肿瘤的治疗,目前治疗方案有限,且尚未达成共识。罕见卵巢恶性肿瘤可出现腹膜转移(PM),其表现与常见卵巢亚型相似。细胞切除手术和腹腔内热化疗(CRS/HIPEC)是治疗非妇科源性卵巢癌以及最近上皮性卵巢癌的有效方法。我们评估了 CRS/HIPEC 治疗罕见卵巢恶性肿瘤的可行性,并报告了这些患者的术后效果。方法 我们对单个中心的前瞻性数据库(1994-2021 年)进行了回顾性审查,以确定接受 CRS/HIPEC 治疗的罕见卵巢恶性肿瘤患者。分析了 Clavien-Dindo 90 天发病率/死亡率、Kaplan-Meier 总生存期(OS)和无进展生存期(PFS)。结果 在确定的 44 名患者中,28 人接受了 CRS/HIPEC。6例患者因病变广泛而流产。组织学亚型包括:透明细胞癌(5/28,17.9%)、类子宫内膜癌(5/28,17.9%)、颗粒细胞癌(3/28,10.7%)、低级别浆液性癌(6/28,21.4%)、间质细胞癌(1/28,3.6%)、粘液腺癌(6/28,21.4%)和小细胞癌(2/28,7.1%)。8名患者(28.6%)患有原发性疾病,20名患者(71.4%)患有复发性疾病。腹膜癌指数(PCI)中位数为 21(IQR:6-29)。27/28(96.4%)名患者实现了完全细胞减灭术(残留病灶小于 2.5 毫米)。9/28(32.1%)例出现了 III/IV 级并发症,其中 1 例(3.6%)死亡。中位随访 65.8 个月后,20 名患者存活。五年的OS和PFS分别为68.5%和52.6%。结论 对于罕见卵巢恶性肿瘤 PM 患者,CRS/HIPEC 是可行的,其安全性也是可以接受的。需要进行更长时间的随访和多中心试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
2.50
自引率
11.10%
发文量
23
审稿时长
9 weeks
期刊最新文献
Do all patients that undergo a ‘complete’ secondary cytoreductive surgery for platinum-sensitive recurrent ovarian cancer, benefit from it? In vitro 3D microfluidic peritoneal metastatic colorectal cancer model for testing different oxaliplatin-based HIPEC regimens. Ascites does not accompany pleural effusion developing under dasatinib therapy in patients with CML-CP. Active surveillance for low-grade appendiceal mucinous neoplasm (LAMN) Peritoneal mestastases from rare ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC)
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1