Secondary cytoreductive surgery, hyperthermic intraperitoneal intraoperative chemotherapy, and chemotherapy alone: A retrospective comparison of alternative approaches in relapsed platinum sensitive ovarian cancer

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Abstract

Introduction: The best treatment for relapsed platinum sensitive epithelial ovarian cancer (EOC) is controversial. The aim of the study was to compare progression-free survival (PFS) and overall survival (OS) in platinum-sensitive EOC patients treated with chemotherapy alone (CTA), secondary cytoreductive surgery (SCR) or SCR plus hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC). Materials and Methods: Retrospective analysis of the clinical outcome of 46 EOC patients with at least 30 months of follow-up. Results: Median follow-up time was 32 months for the CTA group, 30 months for the SCR group, and 45 months for the SCR + HIPEC group. Fifteen recurrences were observed in the CTA group, seven in the SCR group, and 16 in the SCR + HIPEC group. The median time elapsed between first and second recurrence (PFI-2) was significantly higher among patients treated with SCR + HIPEC, in comparison with patients treated with CTA (p = 0.012 and p = 0.017, respectively). On the contrary, PFI-2 did not significantly differ between the SCR and SCR + HIPEC groups (p = 0.877). A statistically significant difference in OS favouring SCR + HIPEC in comparison with CTA (p = 0.04) was observed. Conclusions: SCR ± HIPEC compared with CTA improves PFI-2 in patients with platinum-sensitive EOC recurrence. SCR + HIPEC might also improve OS in comparison with CTA. No improvement in favor of SCR + HIPEC vs SCR was observed,. These results further support the need of a randomized trial comparing chemotherapy with SCR ± HIPEC in this setting.

Original languageEnglish
Pages (from-to)638-643
Number of pages6
JournalEuropean Journal of Gynaecological Oncology
Volume37
Issue number5
DOIs
Publication statusPublished - 2016

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Platinum
Ovarian Neoplasms
Drug Therapy
Recurrence
Survival

Keywords

  • Cytoreductive surgery
  • HIPEC
  • Ovarian cancer
  • Platinum based chemotherapy
  • Platinum sensitive relapse
  • Secondary cytoreduction

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

@article{c08ab8d30a564f96bb9371b755725a27,
title = "Secondary cytoreductive surgery, hyperthermic intraperitoneal intraoperative chemotherapy, and chemotherapy alone: A retrospective comparison of alternative approaches in relapsed platinum sensitive ovarian cancer",
abstract = "Introduction: The best treatment for relapsed platinum sensitive epithelial ovarian cancer (EOC) is controversial. The aim of the study was to compare progression-free survival (PFS) and overall survival (OS) in platinum-sensitive EOC patients treated with chemotherapy alone (CTA), secondary cytoreductive surgery (SCR) or SCR plus hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC). Materials and Methods: Retrospective analysis of the clinical outcome of 46 EOC patients with at least 30 months of follow-up. Results: Median follow-up time was 32 months for the CTA group, 30 months for the SCR group, and 45 months for the SCR + HIPEC group. Fifteen recurrences were observed in the CTA group, seven in the SCR group, and 16 in the SCR + HIPEC group. The median time elapsed between first and second recurrence (PFI-2) was significantly higher among patients treated with SCR + HIPEC, in comparison with patients treated with CTA (p = 0.012 and p = 0.017, respectively). On the contrary, PFI-2 did not significantly differ between the SCR and SCR + HIPEC groups (p = 0.877). A statistically significant difference in OS favouring SCR + HIPEC in comparison with CTA (p = 0.04) was observed. Conclusions: SCR ± HIPEC compared with CTA improves PFI-2 in patients with platinum-sensitive EOC recurrence. SCR + HIPEC might also improve OS in comparison with CTA. No improvement in favor of SCR + HIPEC vs SCR was observed,. These results further support the need of a randomized trial comparing chemotherapy with SCR ± HIPEC in this setting.",
keywords = "Cytoreductive surgery, HIPEC, Ovarian cancer, Platinum based chemotherapy, Platinum sensitive relapse, Secondary cytoreduction",
author = "F. Marocco and M. Vaira and A. Milani and S. Genta and F. Maggiorotto and A. Magistris and A. Cinquegrana and M. Robella and {De Simone}, M. and M. Aglietta and R. Ponzone and G. Valabrega",
year = "2016",
doi = "10.12892/ejgo3257.2016",
language = "English",
volume = "37",
pages = "638--643",
journal = "European Journal of Gynaecological Oncology",
issn = "0392-2936",
publisher = "S.O.G. CANADA Inc.",
number = "5",

}

TY - JOUR

T1 - Secondary cytoreductive surgery, hyperthermic intraperitoneal intraoperative chemotherapy, and chemotherapy alone

T2 - A retrospective comparison of alternative approaches in relapsed platinum sensitive ovarian cancer

AU - Marocco, F.

AU - Vaira, M.

AU - Milani, A.

AU - Genta, S.

AU - Maggiorotto, F.

AU - Magistris, A.

AU - Cinquegrana, A.

AU - Robella, M.

AU - De Simone, M.

AU - Aglietta, M.

AU - Ponzone, R.

AU - Valabrega, G.

PY - 2016

Y1 - 2016

N2 - Introduction: The best treatment for relapsed platinum sensitive epithelial ovarian cancer (EOC) is controversial. The aim of the study was to compare progression-free survival (PFS) and overall survival (OS) in platinum-sensitive EOC patients treated with chemotherapy alone (CTA), secondary cytoreductive surgery (SCR) or SCR plus hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC). Materials and Methods: Retrospective analysis of the clinical outcome of 46 EOC patients with at least 30 months of follow-up. Results: Median follow-up time was 32 months for the CTA group, 30 months for the SCR group, and 45 months for the SCR + HIPEC group. Fifteen recurrences were observed in the CTA group, seven in the SCR group, and 16 in the SCR + HIPEC group. The median time elapsed between first and second recurrence (PFI-2) was significantly higher among patients treated with SCR + HIPEC, in comparison with patients treated with CTA (p = 0.012 and p = 0.017, respectively). On the contrary, PFI-2 did not significantly differ between the SCR and SCR + HIPEC groups (p = 0.877). A statistically significant difference in OS favouring SCR + HIPEC in comparison with CTA (p = 0.04) was observed. Conclusions: SCR ± HIPEC compared with CTA improves PFI-2 in patients with platinum-sensitive EOC recurrence. SCR + HIPEC might also improve OS in comparison with CTA. No improvement in favor of SCR + HIPEC vs SCR was observed,. These results further support the need of a randomized trial comparing chemotherapy with SCR ± HIPEC in this setting.

AB - Introduction: The best treatment for relapsed platinum sensitive epithelial ovarian cancer (EOC) is controversial. The aim of the study was to compare progression-free survival (PFS) and overall survival (OS) in platinum-sensitive EOC patients treated with chemotherapy alone (CTA), secondary cytoreductive surgery (SCR) or SCR plus hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC). Materials and Methods: Retrospective analysis of the clinical outcome of 46 EOC patients with at least 30 months of follow-up. Results: Median follow-up time was 32 months for the CTA group, 30 months for the SCR group, and 45 months for the SCR + HIPEC group. Fifteen recurrences were observed in the CTA group, seven in the SCR group, and 16 in the SCR + HIPEC group. The median time elapsed between first and second recurrence (PFI-2) was significantly higher among patients treated with SCR + HIPEC, in comparison with patients treated with CTA (p = 0.012 and p = 0.017, respectively). On the contrary, PFI-2 did not significantly differ between the SCR and SCR + HIPEC groups (p = 0.877). A statistically significant difference in OS favouring SCR + HIPEC in comparison with CTA (p = 0.04) was observed. Conclusions: SCR ± HIPEC compared with CTA improves PFI-2 in patients with platinum-sensitive EOC recurrence. SCR + HIPEC might also improve OS in comparison with CTA. No improvement in favor of SCR + HIPEC vs SCR was observed,. These results further support the need of a randomized trial comparing chemotherapy with SCR ± HIPEC in this setting.

KW - Cytoreductive surgery

KW - HIPEC

KW - Ovarian cancer

KW - Platinum based chemotherapy

KW - Platinum sensitive relapse

KW - Secondary cytoreduction

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U2 - 10.12892/ejgo3257.2016

DO - 10.12892/ejgo3257.2016

M3 - Article

AN - SCOPUS:84994434531

VL - 37

SP - 638

EP - 643

JO - European Journal of Gynaecological Oncology

JF - European Journal of Gynaecological Oncology

SN - 0392-2936

IS - 5

ER -