Peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 626 patients

Seance of friday 30 march 2012 (SEANCE COMMUNE AVEC LA SOCIETE DE CHIRURGIE DE LYON)

Abstract

Purpose. Despite a high response rate to front-line therapy, prognosis of Epithelial Ovarian Carcinoma (EOC) remains poor. Approaches that combine Cyto-Reductive Surgery (CRS) and Hyperthermic Intra-Peritoneal Chemotherapy (HIPEC) have been developed recently. The purpose of this study was to assess early and long-term survival in patients treated with this strategy.Patients and methods. A retrospective-cohort multicentric study from French centers was performed. All consecutive patients with advanced and recurrent EOC treated with CRS and HIPEC were included.Results. The study included 626 patients from 13 centers who underwent 666 procedures between 1991 and 2010. There were 161 patients with advanced EOC (first-line treatment), and 417 patients with recurrent EOC. A complete cytoreductive surgery was performed in 74,7 % of patients. Mortality and grades 3 to 4 morbidity rates were 1 % and 31 %, respectively. The median overall and recurrence-free survivals were 41,8 months and 12,8 months, respectively. There was no significant difference in overall survival between patients with chemosensitive and with chemoresistant recurrence. The positive independent prognostic factors were the complete cytoreductive surgery, a lower PCI and lower ASA(American Society of Anesthesiology) score.Conclusion. For advanced and recurrent EOC, curative therapeutic approach combining optimal CRS and HIPEC should be considered if complete cytoreductive surgery is feasible. With limited mortality and morbidity rates, it may achieve long-term survival in patients with a severe prognosis disease, even in patients with chemoresistant disease.