Treatment and Prognostic Factors in Primary Peritoneal Carcinoma: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO)

Abstract

Background: In this study, we aimed to evaluate the clinicopathological characteristics and prognosis of patients with primary peritoneal carcinoma (PPC), and the effectiveness and toxicity of first-line platinum/taxane combination therapy. Patients and Methods: We retrospectively evaluated 79 patients with PPC, who were treated and followed up between December 2001 and August 2012 at 10 medical oncology clinics. Results: All patients were female, with a median age of 63 years (range 34-79 years). Histopathological diagnoses included primary peritoneal serous carcinoma (PPSC) (n = 69) and mixed epithelial carcinoma of the peritoneum (MEC) (n = 10). Patients received first-line treatment with carboplatin/paclitaxel (n = 67) or cisplatin/paclitaxel (n = 12) combination therapy. Overall response rate, median progression-free survival, and median survival time in the paclitaxel/carboplatin group and the paclitaxel/cisplatin group were 74.6 vs. 75%, 15.6 vs. 37.8 months, and 41 vs. 70.3 months, respectively. In multivariate analysis, favorable prognostic factors were: ECOG performance status 0 (p < 0.001) and optimal cytoreduction (p = 0.03). Conclusion: PPC is a rare, heterogeneous disease. ECOG performance status and optimal cytoreduction are important prognostic factors regarding survival rates. Platinum/taxane combination therapy is an effective and tolerable regimen in this patient group.

Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy for the treatment of primary peritoneal serous carcinoma: Results of a Chinese retrospective study

“…The study also demonstrated no statistically significant difference in OS between group A and group B, which suggests that CRS þ HIPEC is equally effective in treating PPSC regardless of whether it is performed as the first treatment or at recurrence. Several case studies, and small-sample retrospective studies [3,9,[27][28][29][30][31][32][33][34], a single-institution large-sample retrospective study [11], and two prospective studies [4,35] have reported median OS ranging from 17.0-101.7 months for PPSC patients (Table 3). A systemic review by Pentheroudakis et al [10] evaluated 25 clinical trials on PPSC in three time periods: before 1990, when platinum-and alkylator-based chemotherapy were considered standard, during the 1990s, when platinum combinations without taxanes were the standard treatment, and after 1995, when platinum/taxane combinations were the standard therapy.…”

“…PPSC is a rare and heterogeneous tumour that is diagnosed at approximately one tenth the frequency of epithelial ovarian cancer [2]. PPSC is an extra-ovarian malignancy that spreads widely inside the peritoneal cavity, primarily in the omentum and peritoneal surface with intact ovaries or minimal ovarian involvement, and is found predominantly in elderly and post-menopausal women [3,4]. This malignancy is also diagnosed in women many years after an oophorectomy for benign diseases or a prophylactic oophorectomy in women with a hereditary susceptibility to ovarian cancer.…”

Narrative review on serous primary peritoneal carcinoma of unknown primary site: four questions to be answered

“…A total peritonectomy (residual tumor <1-2 cm) is feasible in 13-79% of patients and should be performed to remove precursor sites and microscopic residual disease (98). Complete resection sorts out one of the most important prognostic factors affecting survival as residual tumors are reported in 60% of grossly normal-appearing peritoneum (99)(100)(101). The rates of lymph node involvement are similar between SPPC and primary ovarian tumor however the approach for lymph node dissection is different between the two entities.…”

Primary peritoneal serous carcinoma, an extremely rare malignancy: A case report and review of the literature

“…The optimal treatment of PPSC is surgical resection and chemotherapy, with platinum-based chemotherapy used most commonly (10). Intraperitoneal chemotherapy has recently demonstrated a survival benefit in patients with PPSC when compared to those treated with surgery alone or surgery in combination with systemic chemotherapy (11).…”