title: Prognostic factors and outcomes of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer - A single tertiary institution experience.
abstract: OBJECTIVE
  Ovarian cancer (OC) ranks fifth in mortality among females cancer patients. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) have radically changed the treatment of OC. The aim of this study was to evaluate overall survival (OS) and disease-free survival (DFS) in our patient population after the application of combined CRS and HIPEC treatment.
  
  
  METHODS
  The study included patients who met defined inclusion and exclusion criteria and had undergone CRS of peritoneal carcinomatosis from 2006 to 2011. Tumor extension was intraoperatively calculated using peritoneal cancer index (PCI). After CRS had been performed, selected patients underwent closed HIPEC. Assessment of successful surgery was estimated with the completeness of cytoreduction score.
  
  
  RESULTS
  The study involved 31 patients. The median DFS was 19 months. The DFS for 1 and 2-year period were 69.2 and 35.2%, respectively. The mean OS was 51 months. The 1-, 2- and 5-year OS was 85.4, 63.3 and 56.3%, respectively. PCI ranged from 1 to 24 and the majority (77.4%) of the patients had PCI score below 13. The most frequent carcinomatosis was observed in the omentum (80.6%), followed by adnexae (61.3%), uterus (58.1%), colon (58.1%). spleen (25.8%), diaphragm (25.8%), small intestine (19.4%), bursa omentalis 19.4, liver (9.7%), and pancreas (3.2%).
  
  
  CONCLUSIONS
  The results of the current study are in concordance with the literature which clearly favors combined the CRS and HIPEC treatment. The reported data suggest that this method could be successfully applied in our region and outline the necessity of future multicentric studies that will involve major regional hospitals.
authors.affiliation: Clinic of Surgical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
authors.forename: Milan
authors.initials: M
authors.lastname: Kocic
authors.forename: Srdjan
authors.initials: S
authors.lastname: Nikolic
authors.forename: Milan
authors.initials: M
authors.lastname: Zegarac
authors.forename: Igor
authors.initials: I
authors.lastname: Djurisic
authors.forename: Ivan
authors.initials: I
authors.lastname: Soldatovic
authors.forename: Petar
authors.initials: P
authors.lastname: Milenkovic
authors.forename: Jovana
authors.initials: J
authors.lastname: Kocic
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000401:mortality; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D016016:Proportional Hazards Models; D012307:Risk Factors; D055771:Serbia; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents