Abstract
BackgroundTo investigate the efficacy and safety of interval debulking surgery (IDS) combined with dense hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in Chinese patients with FIGO stage III serous epithelial ovarian cancer (EOC).MethodsThis retrospective single-center study reviewed the demographic and clinical data of 197 patients with primary FIGO stage III serous EOC who were treated with IDS with (n = 121) or without (n = 76, control group) dense HIPEC between January 2012 and April 2017. The co-primary endpoints were progression-free survival (PFS) and overall survival (OS), and the secondary endpoint was the occurrence of adverse events.ResultsThe median PFS was 24 months in the IDS plus dense HIPEC group, whereas it was 19 months in the IDS alone group (hazard ratio [HR] 0.46, 95% confidence interval [CI]: 0.33–0.65, p = 0.000). The median OS in patients treated with IDS plus dense HIPEC (51 months) was significantly longer than that in patients treated with IDS alone (40 months, HR 0.52, 95% CI: 0.35–0.78, p = 0.001). The demographic and preoperative clinical characteristics of these two groups were comparable (p > 0.05). In the IDS alone group, no adverse events were recorded in 42 (55.3%) of the 76 patients, and 14 (18.4%) patients were reported to have grade III/IV adverse events. In the IDS plus dense HIPEC group, no adverse events were recorded in 55 (45.5%) of the 121 patients, and 23 (19.0%) patients were reported to have grade III/IV adverse events. No postoperative deaths occurred within 30 days in either group and neither did severe fatal complications in the IDS plus dense HIPEC group.ConclusionsIDS plus dense HIPEC with cisplatin in Chinese patients with FIGO stage III serous EOC is associated with improved survival and is reasonably well tolerated by patients.
Highlights
To investigate the efficacy and safety of interval debulking surgery (IDS) combined with dense hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in Chinese patients with FIGO stage III serous epithelial ovarian cancer (EOC)
Complete cytoreductive surgery was defined as surgery that resulted in no visible disease, optimal cytoreductive surgery as surgery that resulted in the presence of one or more residual tumors measuring ≤1 cm in diameter (R1), and incomplete cytoreductive surgery as surgery that resulted in the presence of one or more residual lesions measuring > 1 cm in diameter (R2) [27]
In the IDS plus dense HIPEC group, patients were treated with a mean of 2.95 (SD = 0.62) cycles of neoadjuvant chemotherapy (NACT) compared with 2.86 (SD = 0.60) cycles in the IDS alone group (p = 0.442)
Summary
To investigate the efficacy and safety of interval debulking surgery (IDS) combined with dense hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in Chinese patients with FIGO stage III serous epithelial ovarian cancer (EOC). The most effective treatment for advanced EOC remains primary cytoreductive surgery (CRS) followed by intravenous chemotherapy with carboplatin and paclitaxel [3, 4]. Randomized trials, meta-analyses, and retrospective studies have all shown that HIPEC is feasible and associated with prolonged ovarian cancer survival rates [13,14,15]. In a meta-analysis of patients with primary EOC, Huo et al showed that HIPEC combined with CRS was associated with a significantly improved 2-, 3-, 4-, 5-, and 8-year OS compared with CRS alone [17]
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