Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for endometrial cancer-derived peritoneal metastases: a systematic review
| Autor: | Peter Kern, Ziad Hilal, Clemens B. Tempfer, Günther A. Rezniczek, Askin Dogan |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty medicine.medical_treatment Gastroenterology 03 medical and health sciences 0302 clinical medicine Surgical oncology Internal medicine Humans Medicine Doxorubicin Adverse effect Peritoneal Neoplasms Chemotherapy business.industry Endometrial cancer Cytoreduction Surgical Procedures Hyperthermia Induced General Medicine Middle Aged medicine.disease Combined Modality Therapy Endometrial Neoplasms Clinical trial 030104 developmental biology Oncology 030220 oncology & carcinogenesis Conventional PCI Female Hyperthermic intraperitoneal chemotherapy business medicine.drug |
| Zdroj: | Clinical & Experimental Metastasis. 36:321-329 |
| ISSN: | 1573-7276 0262-0898 |
| DOI: | 10.1007/s10585-019-09970-5 |
| Popis: | Cytoreductive surgery (CRS) is an appropriate treatment for selected patients with endometrial cancer (EC)-derived peritoneal metastases (PM). Hyperthermic intraperitoneal chemotherapy (HIPEC) may enhance the therapeutic efficacy of CRS in these patients. We performed a systematic literature search of the databases PubMed and Cochrane Central Register of Controlled Trials to identify clinical trials and case reports reporting on the safety and efficacy of CRS and HIPEC in patients with EC-derived PM. Eight publications reporting on 68 patients were identified. The mean patient age was 57.1 years and the mean time from initial treatment of EC to CRS and HIPEC was 22.3 months. 41/64 patients had adenocarcinomas, type II cancers were present in 23/64 patients. The mean peritoneal carcinomatosis index (PCI) was 16.7. A complete surgical resection CC-0 was achieved in 44/63 (70%) patients. The chemotherapy regimens used for HIPEC were variable, but all included cisplatin, administered either alone (39/68 patients) or combined with doxorubicin or paclitaxel or mitomycin (29/68 patients). The duration of HIPEC was 60 min in 51/68 patients and 90 min in 17/68 patients. Mostly, the closed technique was used (55/68 patients). Adverse events grades 1/2, 3, and 4 were observed in 23/63, 12/63, and 6/63 patients, respectively. Treatment-associated mortality was 1% (1/63). After CRS and HIPEC, most patients received systemic chemotherapy (46/63 patients). Median disease-free and overall survival ranged from 7 to 18 and 12 to 33 months, respectively. In conclusion, CRS and HIPEC in EC with PM is safe and feasible. An additional therapeutic value of HIPEC is suggested, but prospective comparative trials are warranted. |
| Databáze: | OpenAIRE |
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