%0 Journal Article
%A Foster, Jason M
%A Sleightholm, Richard
%A Smith, Lynette
%A Ceelen, Wim
%A Deraco, Marcello
%A Yildirim, Yusuf
%A Levine, Edward
%A Muñoz-Casares, Cristobal
%A Glehen, Olivier
%A Patel, Asish
%A Esquivel, Jesus
%T The American Society of Peritoneal Surface Malignancies Multi-Institution Evaluation of 1,051 Advanced Ovarian Cancer Patients Undergoing Cytoreductive Surgery and HIPEC: An Introduction of the Peritoneal Surface Disease Severity Score
%D 2016
%U http://hdl.handle.net/10668/13041
%X Background: Standard treatment for ovarian epithelial cancer (OEC) consists of cytoreductive surgery (CRS) and a platinum-taxane chemotherapy combination. There is increasing interest in evaluating hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with stage IIIC/IV disease. The peritoneal surface disease severity score (PSDSS) was introduced as a basis to improve patient selection for this therapy in OEC. Methods: The charts of 1,051 patients with advanced OEC who underwent CRS/HIPEC were retrospectively evaluated using the following preoperatively obtained criteria: symptoms, peritoneal dissemination, and tumor histology. Overall survival was analyzed according to PSDSS as well as the timings and agents used during CRS/HIPEC. Results: Median survival for all 1,051 patients was 73.4 months. PSDSS information was available for 553 patients. Survival correlated negatively with PSDSS (P < 0.001). Furthermore, combining PSDSS scores into I/II and III/IV described two distinct patient populations with vastly different outcomes, 100 versus 55 months, respectively (P < 0.001). Multivariate analysis failed to describe any differences between timings of HIPEC or chemotherapy agents used. Conclusion: PSDSS was capable of identifying a better surviving patient population in advanced-stage OEC. While randomized trials to evaluate the benefit of HIPEC are needed, the PSDSS may be a useful tool for selecting and stratifying OEC patients in clinical trials.
%K PSDSS
%K OEC ovarian epithelial cancer 
%K CRS 
%K HIPEC
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