title: Outcomes Following Interval Debulking Surgery in Primary Peritoneal Carcinoma.
abstract: OBJECTIVE
  Primary peritoneal carcinoma (PPC) has a poor prognosis, with a median survival of 11-24 months. Unlike ovarian cancer, there exist no published data on the effectiveness of interval debulking surgery (IDS) in PPC and it is not routine practice. Our series compared outcomes in patients with PPC treated with IDS following chemotherapy versus patients treated with chemotherapy alone.
  
  
  METHODS
  A retrospective case-note analysis was undertaken of all patients diagnosed with PPC in the Pan-Birmingham network between May 2000 and October 2008. Data were analysed for age, performance status, response to chemotherapy, surgical outcomes, subsequent treatments, site of relapse, median progression-free (PFS) and overall (OS) survival. Analysis for PFS and OS was undertaken using both Kaplan-Meier and log-rank analysis.
  
  
  RESULTS
  A total of 44 patients with histologically-proven PPC were identified: 41 patients received chemotherapy with platinum combination or alone; 17/44 (39%) of patients underwent IDS following chemotherapy and 15 of these had optimal debulking; 3/15 (20%) had a complete pathological response. The recurrence rate for the surgical group was 11/17 (65%) including those with suboptimal debulking, whereas disease recurred in 25/27(93%) of the non-surgical group. The median PFS was 25 months (range=8-33 months) in the IDS group compared to 9 months (range=0-30 months) in the non-surgical group (p=0.001). The median OS was 48 months in the IDS group compared to 18 months in the non-surgical group (p=0.0016). The median OS for the whole patient cohort was 32 months.
  
  
  CONCLUSIONS
  The median OS for the whole cohort compares favourably with previously published survival data of 11-24 months. IDS in selected cases of PPC appears to improve median OS and PFS in PPC and we would recommend that surgery is considered as a treatment option in all patients who have a good response to chemotherapy or entry into a clinical trial.
authors.affiliation: University Hospitals of North Midlands NHS Trust, Stoke On Trent, U.K.
authors.forename: Caroline F
authors.initials: CF
authors.lastname: Connolly
authors.affiliation: The Cancer Centre, Queen Elizabeth Hospital, Birmingham, U.K. drsundusyahya@yahoo.co.uk.
authors.forename: Sundus
authors.initials: S
authors.lastname: Yahya
authors.affiliation: Pan-Birmingham Gynaecology Cancer Centre, City Hospital, Birmingham, U.K.
authors.forename: Kiong Kong
authors.initials: KK
authors.lastname: Chan
authors.affiliation: Pan-Birmingham Gynaecology Cancer Centre, City Hospital, Birmingham, U.K.
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.affiliation: Pan-Birmingham Gynaecology Cancer Centre, City Hospital, Birmingham, U.K. Institute of Cancer and genomics sciences, University of Birmingham, Birmingham, U.K.
authors.forename: Sudha
authors.initials: S
authors.lastname: Sundar
authors.affiliation: The Cancer Centre, Queen Elizabeth Hospital, Birmingham, U.K.
authors.forename: Suhail M
authors.initials: SM
authors.lastname: Anwar
authors.affiliation: The Cancer Centre, Queen Elizabeth Hospital, Birmingham, U.K.
authors.forename: Indrajit
authors.initials: I
authors.lastname: Fernando
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Primary peritoneal carcinoma; chemotherapy; interval debulking surgery