title: Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients.
abstract: BACKGROUND
  Despite a high response rate to front-line therapy, prognosis of epithelial ovarian carcinoma (EOC) remains poor. Approaches that combine Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal 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.
  
  
  METHODS
  A retrospective cohort multicentric study from French centres was performed. All consecutive patients with advanced and recurrent EOC treated with CRS and HIPEC were included.
  
  
  RESULTS
  The study included 566 patients from 13 centres who underwent 607 procedures between 1991 and 2010. There were 92 patients with advanced EOC (first-line treatment), and 474 patients with recurrent EOC. A complete cytoreductive surgery was performed in 74.9% of patients. Mortality and grades 3 to 4 morbidity rates were 0.8% and 31.3%, respectively. The median overall survivals were 35.4 months and 45.7 months for advanced and recurrent EOC, respectively. There was no significant difference in overall survival between patients with chemosensitive and with chemoresistant recurrence. Peritoneal Cancer Index (PCI) that evaluated disease extent was the strongest independent prognostic factor for overall and disease-free survival in all groups.
  
  
  CONCLUSIONS
  For advanced and recurrent EOC, curative therapeutic approach combining optimal CRS and HIPEC should be considered as it may achieve long-term survival in patients with a severe prognosis disease, even in patients with chemoresistant disease. PCI should be used for patient's selection.
authors.affiliation: Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Department of Obstetrics and Gynaecology, Pierre Bénite, France; Université Lyon 1, EMR 3738, Lyon, France.
authors.forename: N
authors.initials: N
authors.lastname: Bakrin
authors.forename: J M
authors.initials: JM
authors.lastname: Bereder
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.forename: J M
authors.initials: JM
authors.lastname: Classe
authors.forename: S
authors.initials: S
authors.lastname: Msika
authors.forename: G
authors.initials: G
authors.lastname: Lorimier
authors.forename: K
authors.initials: K
authors.lastname: Abboud
authors.forename: P
authors.initials: P
authors.lastname: Meeus
authors.forename: G
authors.initials: G
authors.lastname: Ferron
authors.forename: F
authors.initials: F
authors.lastname: Quenet
authors.forename: F
authors.initials: F
authors.lastname: Marchal
authors.forename: S
authors.initials: S
authors.lastname: Gouy
authors.forename: P
authors.initials: P
authors.lastname: Morice
authors.forename: C
authors.initials: C
authors.lastname: Pomel
authors.forename: M
authors.initials: M
authors.lastname: Pocard
authors.forename: F
authors.initials: F
authors.lastname: Guyon
authors.forename: J
authors.initials: J
authors.lastname: Porcheron
authors.forename: O
authors.initials: O
authors.lastname: Glehen
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects; D016154:Digestive System Fistula / Q000209:etiology; D018572:Disease-Free Survival; D005260:Female; D005602:France; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D007970:Leukopenia / Q000139:chemically induced; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology; D016016:Proportional Hazards Models; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents
keywords: HIPEC; Hyperthermia; Intraperitoneal chemotherapy; Ovarian cancer; Peritoneal carcinomatosis