Residual tumour less than 0.25 centimetres and positive lymph nodes are risk factors for early relapse in recurrent ovarian peritoneal carcinomatosis treated with cytoreductive surgery, HIPEC and systemic chemotherapy

Arjona‐Sánchez, Álvaro; Rufián-Peña, Sebastián; Artiles, M. Acosta; Sánchez-Hidalgo, Juan Manuel; Casado-Adam, Ángela; Cosano, A.; Thoelecke, H.; Ramnarine, Sharmila; Garcilazo, Dimas; Briceño-Delgado, Javier

doi:10.1080/02656736.2018.1423708

Cited by 9 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Completeness of Cytoreduction Score is considered in literature an important prognosis factor. In our study, patients in which optimal resection was obtained, CC0, presented a protective factor for recurrence and decease, while CC1 proved to be a statistically significant risk factor for relapse, these results being in accordance to other published studies, which reported that the completeness of cancer resection is an independent predictor of the favorable prognosis [20]. Chemotherapy aspects are extremely important in CRS and HIPEC procedures.…”

Section: Discussionsupporting

confidence: 91%

Untitled

2019

JGWH

View full text Add to dashboard Cite

Objective: To emphasize the main factors involved in the recurrence and death of patients diagnosed with advanced ovarian cancer treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Materials and methods: 49 patients with stage III-IV ovarian cancer who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were included in a retrospective case-control study during January 2016-February 2018. Were considered pre-surgical data, aspects regarding the surgery for cytoreduction, emphasizing Peritoneal Carcinomatosis Index, multi-organ resections and Completeness of Cytoreduction Score, but also chemotherapy details; all patients were followed-up for 1 year after the surgical intervention. Patients were divided in 3 groups: Study Group 1 (SG1)-8 patients alive with recurrence, Study Group 2 (SG2)-4 patients who deceased during the first year, Control Group (CG)-37 patients disease free. Results:We observed that mean age was close in CG and SG1 (53.7 y.o., 53.9 y.o.), and slightly higher in SG2. Most patients had prior treatment for ovarian cancer presenting a protective factor for recurrence and death (OR=0.077), together with PCI score under 20 (OR=0.166), postsurgery CC0 score (OR=0.141), platinum sensitivity of the tumors cells (OR=0.117), performed appendectomy (OR=0.181) and omentectomy (OR= 0.141). Main significant risk factors for relapse and death were PCI over 20 (OR=6.042) and CC1 score (OR=4.500). Conclusion:A complete cytoreduction surgery and heated intraperitoneal chemotherapy are able to destroy microscopic tumor residues, existing high-quality data suggesting survival benefits due to these procedures.

show abstract

Section: Discussionsupporting

confidence: 91%

Untitled

2019

JGWH

View full text Add to dashboard Cite

show abstract

“…In this study, we used a residual disease classification (CC0/1/2/3) that is not commonly used to describe ovarian cancer debulking surgery but that is becoming standard practice in surgical oncology. It is classified by more discrete variables that aim to improve the precision of residual disease status reporting and has been used in other ovarian cancer survival analysis studies [33]. The satisfactory survival rates that were established in both the LGSOC and HGSOC patients who underwent a complete surgical cytoreduction (CC 0-1) in our study is in contrast with the poor prognosis of those patients who underwent an incomplete cytoreduction (CC ≥ 2).…”

Section: Discussionmentioning

confidence: 74%

The Uncertain Benefit of Adjuvant Chemotherapy in Advanced Low-Grade Serous Ovarian Cancer and the Pivotal Role of Surgical Cytoreduction

Johnson

Laios

Jackson

et al. 2021

JCM

View full text Add to dashboard Cite

In our center, adjuvant chemotherapy is routinely offered in high-grade serous ovarian cancer (HGSOC) patients but less commonly as a standard treatment in low-grade serous ovarian cancer (LGSOC) patients. This study evaluates the efficacy of this paradigm by analysing survival outcomes and by comparing the influence of different clinical and surgical characteristics between women with advanced LGSOC (n = 37) and advanced HGSOC (n = 300). Multivariate analysis was used to identify independent prognostic features for survival in LGSOC and HGSOC. Adjuvant chemotherapy was given in 99.7% of HGSOC patients versus in 27% of LGSOC (p < 0.0001). The LGSOC patients had greater surgical complexity scores (p < 0.0001), more frequent postoperative ICU/HDU admissions (p = 0.0002), and higher peri-/post-operative morbidity (p < 0.0001) compared to the HGSOC patients. The 5-year OS and progression-free survival (PFS) was 30% and 13% for HGSOC versus 57% and 21.6% for LGSOC, p = 0.016 and p = 0.044, respectively. Surgical complexity (HR 5.3, 95%CI 1.2–22.8, p = 0.024) and complete cytoreduction (HR 62.4, 95% CI 6.8–567.9, p < 0.001) were independent prognostic features for OS in LGSOC. This study demonstrates no clear significant survival advantage of chemotherapy in LGSOC. It highlights the substantial survival benefit of dynamic multi-visceral surgery to achieve complete cytoreduction as the primary treatment for LGSOC patients.

show abstract

“…In two recent meta-analyses (101,102 ) including observational studies and the only RCT on rEOC, CRS + HIPEC showed a significant advantage compared to CRS alone in terms of OS and DFS (if CC-3 patients were excluded). Almost all the studies agree in affirming the completeness of the cytoreduction (CC-0) as the major prognostic factor on OS and DFS (18,34,39,42,44,52,57,69,76). The reported major morbidity and mortality for CRS + HIPEC in patients with rEOC ranges from 8.3 to 72% and from 0 to 22.2% respectively.…”

Section: Hipec With Recurrent Epithelial Ovarian Cancermentioning

confidence: 83%