Purpose: The main objective of the study is to evaluate the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of naïve ovarian cancer women undergoing complete or near-complete cytoreduction by assessing the overall survival, the disease-specific survival, and the disease-free survival. The secondary objective is the identification of prognostic indicators of survival and recurrence of these patients. Patients—Methods: Retrospective study of treatment in naïve women with locally advanced ovarian cancer treated with cytoreductive surgery (CRS) and HIPEC and compared with those who were treated with cytoreduction alone. Clinicopathologic variables were correlated to overall survival, disease-specific survival, and disease-free survival using Kaplan–Meier method, and the multivariate Cox proportional hazards regression models. Results: 5- and 10-year overall survival, disease-specific survival, and disease-free survival rates were significantly higher in patients treated with CRS and HIPEC. These patients were 67% less likely to die from any cause (adjusted hazard ratio, aHR = 0.33,p= 0.001), 75% less likely to die from cancer (aHR = 0.25,p= 0.003), and 46% less likely to develop recurrence (aHR = 0.54,p= 0.041) compared to patients treated with CRS alone. Moreover, the poor performance status (aHR = 2.96,p< 0.001), the serous carcinomas (aHR = 0.14,p= 0.007), and the morbidity (aHR = 6.87,p< 0.001) were identified as independent indicators of poor overall survival. The degree of differentiation (aHR = 8.64,p= 0.003) was identified as the independent indicator of disease-specific survival (aHR = 4.13,p= 0.002), while the extent of peritoneal carcinomatosis (aHR = 2.32,p< 0.001) as the independent indicator of disease-free survival. Conclusions: Treatment in naïve patients with locally advanced ovarian cancer undergoing CRS plus HIPEC appears to have improved overall, disease-specific, and disease-free survival.
目的：本研究的主要目的是通过评估总生存期、疾病特异性生存期和无病生存期，评价腹腔热灌注化疗（HIPEC）在接受完全或接近完全肿瘤细胞减灭术的初治卵巢癌女性患者中的治疗效果。次要目标是识别这些患者生存和复发的预后指标。 患者与方法：本研究为回顾性研究，纳入接受肿瘤细胞减灭术（CRS）联合HIPEC治疗的局部晚期初治卵巢癌女性患者，并与仅接受肿瘤细胞减灭术的患者进行比较。采用Kaplan-Meier法和多变量Cox比例风险回归模型，将临床病理变量与总生存期、疾病特异性生存期和无病生存期进行相关性分析。 结果：接受CRS联合HIPEC治疗的患者，其5年和10年总生存率、疾病特异性生存率和无病生存率均显著更高。与仅接受CRS治疗的患者相比，这些患者全因死亡风险降低67%（校正风险比，aHR = 0.33，p = 0.001），癌症相关死亡风险降低75%（aHR = 0.25，p = 0.003），复发风险降低46%（aHR = 0.54，p = 0.041）。此外，体能状态差（aHR = 2.96，p < 0.001）、浆液性癌（aHR = 0.14，p = 0.007）以及术后并发症（aHR = 6.87，p < 0.001）被确定为总生存期不良的独立预测指标。分化程度（aHR = 8.64，p = 0.003）被确定为疾病特异性生存期的独立预测指标（aHR = 4.13，p = 0.002），而腹膜癌病范围（aHR = 2.32，p < 0.001）则是无病生存期的独立预测指标。 结论：对于接受CRS联合HIPEC治疗的局部晚期初治卵巢癌患者，其总生存期、疾病特异性生存期和无病生存期似乎均有所改善。
HIPEC as Up-Front Treatment in Locally Advanced Ovarian Cancer
肿瘤(癌症)患者之家