title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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. J. Surg. Oncol. 2016;114:779-784. © 2016 2016 Wiley Periodicals, Inc.
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Jason M
authors: JM
authors: Foster
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Richard
authors: R
authors: Sleightholm
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Lynette
authors: L
authors: Smith
authors: Department of Gastrointestinal Surgery, Ghent University Hospital Belgium, Gent, Belgium.
authors: Wim
authors: W
authors: Ceelen
authors: National Cancer Institute of Milan, Milan, Italy.
authors: Marcello
authors: M
authors: Deraco
authors: Department of Gynecologic Oncology, Aegean Obstetrics and Gynecology Education and Research Hospital, Izmir, Turkey.
authors: Yusuf
authors: Y
authors: Yildirim
authors: Department of Surgery, Wake Forest University Baptist Medical Center, Winston Salem, North Carolina.
authors: Edward
authors: E
authors: Levine
authors: Unit of Oncological and Pancreatic Surgery, Department of General and Digestive Surgery, University Hospital Reina Sofia, Cordoba, Spain.
authors: Cristobal
authors: C
authors: Muñoz-Casares
authors: Service de Chirurgie Générale et Oncologique, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
authors: Olivier
authors: O
authors: Glehen
authors: Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
authors: Asish
authors: A
authors: Patel
authors: Department of Surgical Oncology, St. Agnes Hospital, Baltimore, Maryland. jesusesquivel@yahoo.com.
authors: Jesus
authors: J
authors: Esquivel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077216:Carcinoma, Ovarian Epithelial; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012955:Societies, Medical; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: CRS; HIPEC; OEC; PSDSS; ovarian epithelial cancer