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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.

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Date

2018-01-01

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Arjona-Sanchez, Alvaro
Rufian-Peña, Sebastian
Artiles, Manuel
Sanchez-Hidalgo, Juan Manuel
Casado-Adam, Angela
Cosano, Antonio
Thoelecke, Heather
Ramnarine, Sharmila
Garcilazo, Dimas
Briceño-Delgado, Javier

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Taylor & Francis
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The cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has showed promising results for the survival in patients with recurrent ovarian carcinomatosis, however, some of them will recur within the first year. The aim of this study is focussed on identifying the risk factors to develop the recurrence within the first year after an optimal CRS-HIPEC in patients with recurrent ovarian carcinomatosis. A total of 100 patients with peritoneal carcinomatosis from recurrent ovarian cancer treated by CRS + HIPEC were selected for analysis. Multivariate logistic regression analysis was performed to evaluate the relationship between the variables and the early recurrence. The mean follow-up was 42.5 months. The mean age was 56.2 years. Early recurrence was observed in the 36%. The group early recurrence presented a higher rate of optimal cytoreductions CC1 (16.2% vs. 3.5%), lymph nodes (32.5% vs. 15%) and the use of hemoderivates (40.5% vs. 33%). Others parameters as Peritoneal Cancer Index, major morbidity? 3, re-operations rate and time to adjuvant chemotherapy were similar in both groups. The five years OS was 58%, for the non-early recurrence was higher than the early recurrence group (64% vs. 41%). In the multivariate analysis, CC-1 (OR 5.73; 1.16-32.04) and positive lymph nodes (OR 2.26; 1.01-4.32) proved to be independent factors for the early recurrence. The combination of both (CC1 and positive lymph nodes) makes that the indication of CRS and HIPEC should be individualised. However, the major morbidity, stage IV and the time to the adjuvant treatment were not associated with an early recurrence, so that, a major aggressiveness is recommended to achieve a CC0.

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Adult
Aged
Chemotherapy adjuvant
Cytoreduction surgical procedures
Female
Humans
Hyperthermia, induced
Male
Middle aged
Neoplasm recurrence, local
Ovarian neoplasms
Peritoneal neoplasms
Prospective studies
Recurrence
Retrospective studies
Risk factors
Survival analysis

DeCS Terms

Análisis de supervivencia
Hipertermia Inducida
Neoplasias ováricas
Neoplasias peritoneales
Procedimientos quirúrgicos de citorreducción
Quimioterapia
Recurrencia
Recurrencia local de neoplasia

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Keywords

HIPEC, Ovarian cancer, Peritonectomy

Citation

Arjona-Sanchez A, Rufian-Peña S, Artiles M, Sánchez-Hidalgo JM, Casado-Adam Á, Cosano A, et al. 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. Int J Hyperthermia. 2018 Aug;34(5):570-577