A comparison of primary intraperitoneal chemotherapy to consolidation intraperitoneal chemotherapy in optimally resected advanced ovarian cancer.

Autor: Suidan RS; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., St Clair CM; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Lee SJ; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Barlin JN; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Long Roche KC; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Tanner EJ; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Sonoda Y; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA., Barakat RR; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA., Zivanovic O; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA., Chi DS; Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Weill Cornell Medical College, New York, NY, USA. Electronic address: gynbreast@mskcc.org.
Jazyk: angličtina
Zdroj: Gynecologic oncology [Gynecol Oncol] 2014 Sep; Vol. 134 (3), pp. 468-72. Date of Electronic Publication: 2014 Jul 17.
DOI: 10.1016/j.ygyno.2014.07.090
Abstrakt: Objective: To compare survival outcomes for patients with advanced epithelial ovarian cancer (EOC) who received primary intravenous/intraperitoneal (IV/IP) chemotherapy to those who received IV followed by consolidation (treatment given to patients in remission) IP chemotherapy.
Methods: Data were analyzed and compared for all patients with stage III-IV EOC who underwent optimal primary cytoreduction (residual disease ≤ 1 cm) followed by cisplatin-based consolidation IP chemotherapy (1/2001-12/2005) or primary IV/IP chemotherapy (1/2005-7/2011).
Results: We identified 224 patients; 62 (28%) received IV followed by consolidation IP chemotherapy and 162 (72%) received primary IV/IP chemotherapy. The primary IP group had significantly more patients with serous tumors. The consolidation IP group had a significantly greater median preoperative platelet count, CA-125, and amount of ascites. There were no differences in residual disease at the end of cytoreduction between both groups. The median progression-free survival (PFS) was greater for the primary IP group; however, this did not reach statistical significance (23.7 months vs 19.7 months; HR 0.78; 95% CI, 0.57-1.06; p=0.11). The median overall survival (OS) was significantly greater for the primary IP group (78.8 months vs 57.5 months; HR 0.56; 95% CI, 0.38-0.83; p=0.004). On multivariate analysis, after adjusting for confounders, the difference in PFS was not significant (HR 0.78; 95% CI, 0.56-1.11; p=0.17), while the difference in OS remained significant (HR 0.59; 95% CI, 0.39-0.89; p=0.01).
Conclusions: In our study, primary IV/IP chemotherapy was associated with improved OS compared to IV followed by consolidation IP chemotherapy in patients with optimally cytoreduced advanced EOC.
(Copyright © 2014 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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