Interval cytoredutive surgery and HIPEC in advanced ovarian cancer with small-bowel disease: results and reflections.

Autor: Cascales Campos PA; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain., González Gil A; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain. alida_gon_b@hotmail.com., Gómez Ruiz ÁJ; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain., Balaguer Román A; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain., Gil Gómez E; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain., Alconchel Gago F; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain., Martínez J; Servicio de Oncología Médica, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Nieto Díaz A; Unidad de Ginecología Oncológica, Servicio de Ginecología y Obstetricia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Barceló Valcárcel F; Unidad de Ginecología Oncológica, Servicio de Ginecología y Obstetricia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain., Gil Martínez J; Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-Arrixaca, Carretera Madrid/Cartagena S/N, El Palmar, Murcia, Spain.
Jazyk: angličtina
Zdroj: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2022 Aug; Vol. 24 (8), pp. 1542-1548. Date of Electronic Publication: 2022 Mar 10.
DOI: 10.1007/s12094-022-02795-x
Abstrakt: Introduction: Small-bowel involvement in patients with ovarian cancer has been strongly correlated with the possibility of cytoreduction and thus with survival. The main objective of this study was to evaluate the prognostic significance of small-bowel involvement in patients undergoing optimal-complete interval cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
Methods: We included a series of patients diagnosed with stage IIIC-IVA (pleural effusion) high-grade serous epithelial ovarian cancer and in whom CRS + HIPEC was indicated after neoadjuvant systemic chemotherapy (NACT). The study period extended from January 2008 to January 2020, with a minimum follow-up of 12 months from the inclusion of the last patient. A multivariate analysis using Cox regression allowed us to identify the variables that were independently related to disease-free survival.
Results: A total of 144 patients were selected, 13 (9%) of whom were excluded from the analysis, because their disease was considered unresectable. The study included a series of 131 patients with a median age of 62 years (34-79 years) and a median Peritoneal Cancer Index (PCI) calculated during surgery of 9 (1-35). The median PCI of bowel areas 9-12 (SB-PCI) was 3 (1-10). Performance of a CC-1 cytoreduction (HR: 1.93, 95% CI: 1.02-3.64, p = 0.042) and SB-PCI greater than 3 (HR: 2.25, 95%CI: 1.13-4.48, p = 0.21) were independent factors associated with shorter disease-free survival.
Conclusion: Small-bowel involvement, even in patients with a macroscopically complete resection, showed a correlation with worse prognostic outcomes and could be considered as a variable in the postoperative management of these patients.
(© 2022. The Author(s), under exclusive licence to Federación de Sociedades Españolas de Oncología (FESEO).)
Databáze: MEDLINE
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