IV期上皮性卵巢癌患者接受新辅助化疗后细胞减少手术和腹腔热化疗(CRS/HIPEC)的关键分析。

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2020-12-16 eCollection Date: 2020-01-01 DOI:10.1155/2020/1467403
Carlos A Munoz-Zuluaga, Armando Sardi, Michelle Sittig, Vadim Gushchin, Mary C King, Carol Nieroda, Felipe Lopez-Ramirez, Teresa P Diaz-Montes
{"title":"IV期上皮性卵巢癌患者接受新辅助化疗后细胞减少手术和腹腔热化疗(CRS/HIPEC)的关键分析。","authors":"Carlos A Munoz-Zuluaga,&nbsp;Armando Sardi,&nbsp;Michelle Sittig,&nbsp;Vadim Gushchin,&nbsp;Mary C King,&nbsp;Carol Nieroda,&nbsp;Felipe Lopez-Ramirez,&nbsp;Teresa P Diaz-Montes","doi":"10.1155/2020/1467403","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) after neoadjuvant chemotherapy (NACT) showed promise as initial treatment for stage IIIC (SIII) epithelial ovarian cancer (EOC); however, stage IV (SIV) outcomes are rarely reported. We assessed our experience and outcomes treating newly diagnosed SIV EOC with NACT plus CRS/HIPEC compared to SIII patients.</p><p><strong>Methods: </strong>Advanced EOC from 2015-2018 managed with NACT (carboplatin/paclitaxel) due to unresectable disease or poor performance status followed by interval CRS/HIPEC were reviewed. Perioperative factors were assessed. Overall survival (OS) and progression-free survival (PFS) were analyzed by stage.</p><p><strong>Results: </strong>Twenty-seven FIGO stage IIIC (<i>n</i> = 12) and IV (<i>n</i> = 15) patients were reviewed. Median NACT cycles were 3 and 4, respectively. Post-NACT omental caking, ascites, and pleural effusions decreased/resolved in 91%, 91%, and 100% of SIII and 85%, 92%, and 71% of SIV. SIII/SIV median PCI was 21 and 20 obtaining 92% and 100% complete cytoreduction (≤0.25 cm), respectively. Median organ resections were 6 and 7, respectively. Grade III/IV surgical complications were 0% SIII and 23% SIV, without hospital mortality. Median time to adjuvant chemotherapy was 53 and 74 days, respectively (<i>p</i>=0.007). SIII OS at 1 and 2 years was 100% and 83% and 87% and 76% in SIV (<i>p</i>=0.269). SIII 1-year PFS was 54%; median PFS: 12 months. SIV 1- and 2- year PFS was 47% and 23%; median PFS: 12 months (<i>p</i>=0.944).</p><p><strong>Conclusion: </strong>Outcomes in select initially diagnosed and unresectable SIV EOC are similar to SIII after NACT plus CRS/HIPEC. SIV EOC may benefit from CRS/HIPEC, and further studies should explore this treatment approach.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1467403","citationCount":"2","resultStr":"{\"title\":\"Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC).\",\"authors\":\"Carlos A Munoz-Zuluaga,&nbsp;Armando Sardi,&nbsp;Michelle Sittig,&nbsp;Vadim Gushchin,&nbsp;Mary C King,&nbsp;Carol Nieroda,&nbsp;Felipe Lopez-Ramirez,&nbsp;Teresa P Diaz-Montes\",\"doi\":\"10.1155/2020/1467403\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) after neoadjuvant chemotherapy (NACT) showed promise as initial treatment for stage IIIC (SIII) epithelial ovarian cancer (EOC); however, stage IV (SIV) outcomes are rarely reported. We assessed our experience and outcomes treating newly diagnosed SIV EOC with NACT plus CRS/HIPEC compared to SIII patients.</p><p><strong>Methods: </strong>Advanced EOC from 2015-2018 managed with NACT (carboplatin/paclitaxel) due to unresectable disease or poor performance status followed by interval CRS/HIPEC were reviewed. Perioperative factors were assessed. Overall survival (OS) and progression-free survival (PFS) were analyzed by stage.</p><p><strong>Results: </strong>Twenty-seven FIGO stage IIIC (<i>n</i> = 12) and IV (<i>n</i> = 15) patients were reviewed. Median NACT cycles were 3 and 4, respectively. Post-NACT omental caking, ascites, and pleural effusions decreased/resolved in 91%, 91%, and 100% of SIII and 85%, 92%, and 71% of SIV. SIII/SIV median PCI was 21 and 20 obtaining 92% and 100% complete cytoreduction (≤0.25 cm), respectively. Median organ resections were 6 and 7, respectively. Grade III/IV surgical complications were 0% SIII and 23% SIV, without hospital mortality. Median time to adjuvant chemotherapy was 53 and 74 days, respectively (<i>p</i>=0.007). SIII OS at 1 and 2 years was 100% and 83% and 87% and 76% in SIV (<i>p</i>=0.269). SIII 1-year PFS was 54%; median PFS: 12 months. SIV 1- and 2- year PFS was 47% and 23%; median PFS: 12 months (<i>p</i>=0.944).</p><p><strong>Conclusion: </strong>Outcomes in select initially diagnosed and unresectable SIV EOC are similar to SIII after NACT plus CRS/HIPEC. SIV EOC may benefit from CRS/HIPEC, and further studies should explore this treatment approach.</p>\",\"PeriodicalId\":45960,\"journal\":{\"name\":\"International Journal of Surgical Oncology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2020-12-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2020/1467403\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Surgical Oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2020/1467403\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgical Oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/1467403","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 2

摘要

背景:新辅助化疗(NACT)后的细胞减少手术和腹腔内高温化疗(CRS/HIPEC)有望成为IIIC期(SIII)上皮性卵巢癌(EOC)的初始治疗方法;然而,IV期(SIV)的结果很少被报道。我们评估了与SIII患者相比,NACT + CRS/HIPEC治疗新诊断的SIV EOC的经验和结果。方法:回顾2015-2018年因疾病不可切除或表现不佳而采用NACT(卡铂/紫杉醇)治疗的晚期EOC,并随访CRS/HIPEC。评估围手术期因素。分阶段分析总生存期(OS)和无进展生存期(PFS)。结果:回顾了27例FIGO IIIC期(n = 12)和IV期(n = 15)患者。中位NACT周期分别为3和4。nact后,SIII患者的91%、91%和100%以及SIV患者的85%、92%和71%的网膜结块、腹水和胸腔积液减少/消除。SIII/SIV中位PCI分别为21和20,分别获得92%和100%的完全细胞减少(≤0.25 cm)。中位器官切除分别为6例和7例。III/IV级手术并发症为0% SIII和23% SIV,无住院死亡率。辅助化疗的中位时间分别为53天和74天(p=0.007)。SIII的1年和2年OS分别为100%和83%,SIV的87%和76% (p=0.269)。SIII 1年PFS为54%;中位PFS: 12个月。SIV 1年和2年PFS分别为47%和23%;中位PFS: 12个月(p=0.944)。结论:选择最初诊断和不可切除的SIV EOC的结果与NACT + CRS/HIPEC后的SIV EOC相似。SIV EOC可能受益于CRS/HIPEC,进一步的研究应该探索这种治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

摘要图片

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
Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC).

Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) after neoadjuvant chemotherapy (NACT) showed promise as initial treatment for stage IIIC (SIII) epithelial ovarian cancer (EOC); however, stage IV (SIV) outcomes are rarely reported. We assessed our experience and outcomes treating newly diagnosed SIV EOC with NACT plus CRS/HIPEC compared to SIII patients.

Methods: Advanced EOC from 2015-2018 managed with NACT (carboplatin/paclitaxel) due to unresectable disease or poor performance status followed by interval CRS/HIPEC were reviewed. Perioperative factors were assessed. Overall survival (OS) and progression-free survival (PFS) were analyzed by stage.

Results: Twenty-seven FIGO stage IIIC (n = 12) and IV (n = 15) patients were reviewed. Median NACT cycles were 3 and 4, respectively. Post-NACT omental caking, ascites, and pleural effusions decreased/resolved in 91%, 91%, and 100% of SIII and 85%, 92%, and 71% of SIV. SIII/SIV median PCI was 21 and 20 obtaining 92% and 100% complete cytoreduction (≤0.25 cm), respectively. Median organ resections were 6 and 7, respectively. Grade III/IV surgical complications were 0% SIII and 23% SIV, without hospital mortality. Median time to adjuvant chemotherapy was 53 and 74 days, respectively (p=0.007). SIII OS at 1 and 2 years was 100% and 83% and 87% and 76% in SIV (p=0.269). SIII 1-year PFS was 54%; median PFS: 12 months. SIV 1- and 2- year PFS was 47% and 23%; median PFS: 12 months (p=0.944).

Conclusion: Outcomes in select initially diagnosed and unresectable SIV EOC are similar to SIII after NACT plus CRS/HIPEC. SIV EOC may benefit from CRS/HIPEC, and further studies should explore this treatment approach.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
期刊最新文献
The Sublingual Gland Flap for Oral Reconstruction: Insights From a Single Institutional Experience. Novel Index Combining Pan-Immune-Inflammatory Index and Hemoglobin Levels (PIV/Hb) Predicts Trismus Rates Efficiently after Chemoradiotherapy in Locally Advanced Nasopharyngeal Cancer. Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending Fracture Fixation. Differentiated Thyroid Carcinoma Long-Term Prognostic Factors. Risk Factors of Oral Squamous Cell Carcinoma with Special Emphasis on Areca Nut Usage and Its Association with Clinicopathological Parameters and Recurrence.
×
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