Objective(s): To identify recurrence patterns and outcomes in women with advanced or recurrent epithelial ovarian cancer (EOC) after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods: This is an IRB-approved single-institution cohort study of women who underwent CRS+HIPEC for advanced or recurrent EOC followed in a prospective registry from 1/12/2014-3/1/2020. Recurrence locations were defined as pelvic, upper abdominal (UA) and/or extra-peritoneal (EP). Univariate analysis assessed associations between recurrence location, progression-free survival (PFS), and overall survival (OS).
Results: In total, 92 women with EOC underwent interval (56.5%; n=52) or recurrent CRS+HIPEC (43.5%; n=40). For interval CRS+HIPEC, recurrence locations were pelvic in 50.0% (n=15), UA in 23.3% (n=7) and EP in 56.7% (n=17); 40.0% (n=12) were EP alone. Similarly, for recurrent CRS+HIPEC, recurrence locations were pelvic (22.5%, n=9), UA (5.0%, n=2) and EP (60.0%, n=24); 66.7% (n=20) were EP alone. For both interval and recurrent CRS+HIPEC, median PFS was 10.5 vs. 13.0 months for pelvic and UA vs. EP only recurrences (p=0.02). Similarly, median OS was 29.2 months for pelvic and UA and not reached for EP only (p=0.05). For interval CRS+HIPEC, there was no difference in median PFS (10.6 vs. 11.7 months, p=0.68) and OS (27.1 vs. 24.8 months, p=0.96) for pelvic and UA vs EP alone. However, for recurrent CRS+HIPEC, pelvic and UA sites of recurrence were associated with reduced PFS (10.0 vs. 18.1 months, p=0.03) and OS (33.6 months vs. not reached, p=0.02) vs. EP only.
Conclusions: In women with advanced or recurrent EOC undergoing CRS+HIPEC, one-half of patients experience their first recurrence outside of the peritoneal cavity. Providers must be aware of the risk of EP failure in patients treated with CRS+HIPEC.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ygyno.2021.01.039 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pathological complete response after chemotherapy in initially unresectable distal cholangiocarcinoma.
Clin J Gastroenterol
December 2024
Department of Diagnostic Pathology, National Hospital Organization Shizuoka Medical Center, 762-1 Nagasawa, Shimizu, Sunto District, Shizuoka, 411-0904, Japan.
Surgical resection is the only curative treatment for cholangiocarcinoma, but it is often diagnosed at advanced stages, making surgical resection infeasible. Recently, the concept of conversion surgery has expanded the indications for surgical treatment, thanks to advancements in both perioperative management and chemotherapy. However, it remains unclear which patients benefit most from this treatment strategy.
View Article and Find Full Text PDFRobot-Assisted Laparoscopic Sacrohysteropexy with Autologous Fascia Lata.
Int Urogynecol J
December 2024
Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, 3168, Australia.
Introduction And Hypothesis: Autologous fascia lata has been increasingly utilised in pelvic floor reconstructive surgeries such as sacrocolpopexy and sacrohysteropexy. This case highlights sacrohysteropexy with autologous fascia lata as a promising option for women with advanced uterovaginal prolapse who wish to preserve their uterus and avoid synthetic mesh.
Methods: We report the case of a 65-year-old woman with stage 3 pelvic organ prolapse following one forceps and one spontaneous vaginal delivery.
Oncolytic measles virus-induced cell killing in radio-resistant and drug-resistant nasopharyngeal carcinoma.
Malays J Pathol
December 2024
Universiti Tunku Abdul Rahman, M. Kandiah Faculty of Medicine and Health Sciences, Department of Pre-clinical Sciences, Bandar Sungai Long, 43000, Kajang, Selangor, Malaysia.
Introduction: The current first-line therapy for nasopharyngeal carcinoma (NPC) is often associated with long-term complications. Oncolytic measles virus (MV) therapy offers a promising alternative to cancer therapy. This study aims to investigate the efficacy of MV in killing NPC cells in vitro, both with or without resistance to radiation and drug therapy.
View Article and Find Full Text PDFThe Burden of Recurrent Head and Neck Squamous Cell Carcinoma Across the United Kingdom: Results From a National Snapshot Study.
Head Neck
December 2024
Head and Neck Unit, The Royal Marsden Hospital, London, UK.
Background: To investigate the management of recurrent head and neck squamous cell carcinoma (rHNSCC) and describe survival outcomes.
Methods: Post hoc subgroup analysis of a retrospective national observational cohort was conducted. All patients with rHNSCC who received a definitive treatment decision between September 1, 2021 and November 30, 2021 were included.
Perioperative Changes in Serum Transaminases Levels Predicts Long-Term Survival Following Liver Resection of Hepatocellular Carcinoma.
Ann Surg Oncol
December 2024
Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
Background: We sought to define whether and how hepatic ischemia/reperfusion (I/R) as manifested by perioperative aspartate aminotransferase (AST) and alanine aminotransaminase (ALT) levels impact long-term outcomes after curative-intent resection of hepatocellular carcinoma (HCC).
Patients And Methods: Intrasplenic injection of HCC cells was used to establish a murine model of HCC recurrence with versus without I/R injury. Patients who underwent curative resection for HCC were identified from a multi-institutional derivative cohort (DC) and separate external validation (VC) cohort.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!