Long-Term Survival for Platinum-Sensitive Recurrent Ovarian Cancer Patients Treated with Secondary Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

Abstract

To analyze the 5- and 7-year survival outcomes for women with platinum-sensitive recurrent epithelial ovarian cancer (REOC) who underwent secondary cytoreductive surgery (SCS) plus platinum-based hyperthermic intraperitoneal chemotherapy (HIPEC). From the electronic databases of the Department of Obstetrics and Gynecology at the Catholic University of the Sacred Heart of Rome and of the S. Orsola Hospital, University of Bologna, a consecutive series of REOC patients were selected using the following inclusion criteria: primary platinum-free interval (PFI-1) of 6months or longer, completeness of secondary cytoreduction score (CC) of 1 or lower, minimum follow-up period of 48months, Eastern Cooperative Group (ECOG) performance status at recurrence of 1 or less, and platinum-based HIPEC. Progression-free survival (PFS) and post-relapse survival (PRS) were calculated as the time between SCS+HIPEC and secondary recurrence or death, respectively. The final study population included 70 women with platinum-sensitive REOC. The median follow-up time was 73months (range 48-128months), and the median PFI-1 was 19months (range 6-100months). At the time of recurrence, the median peritoneal cancer index was 7 (range 1-21), and a CC score of 0 was achieved for 62 patients (88.6%). As the HIPEC drug, we used oxaliplatin in 17 cases (38.6%) and cisplatin in 43 cases (61.4%). No postoperative deaths were observed, and the complication rate for grades 3 and 4 disease was 8.6%. The median PFS duration was 27months (range 5-104months), and the 5- and 7-year PRS rates were respectively 52.8 and 44.7%, (median PRS 63months). The current study demonstrated favorable 5- and 7-year PRS rates for platinum-sensitive REOC patients undergoing SCS+HIPEC, which encourages the inclusion of patients in randomized clinical trials for definitive conclusions to be drawn.