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abstract
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
Background
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.
Methods
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.
Results
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.
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