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Cytoreduction and HIPEC after neoadjuvant chemotherapy in stage IIIC-IV ovarian cancer. Critical analysis in elderly patients.

Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:88-93. doi: 10.1016/j.ejogrb.2014.05.018. Epub 2014 Jun 2.

Cascales-Campos P1, Gil J2, Gil E2, Feliciangeli E3, López V2, Gonzalez AG2, Ruiz-Pardo J2, Nieto A4, Parrilla P2.

Eur J Obstet Gynecol Reprod Biol
AbstractOBJECTIVES: The aim of our study was to evaluate postoperative morbidity and mortality, disease-free and overall survival in patients older than 75 years undergoing interval debulking after neoadjuvant chemotherapy and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC).STUDY DESIGN: Were included a series of consecutive patients diagnosed with stages IIIC/IV ovarian carcinoma, intervened after neoadjuvant systemic chemotherapy (paclitaxel and carboplatin) between January 2008 and June 2013. After completion of cytoreduction HIPEC was administered using paclitaxel (60mg/m(2)) or cisplatin (75mg/m(2)). We analyzed and compared the results of postoperative morbidity and mortality, disease-free survival and overall survival in patients =75 years compared to patients with lower ages intervened in the same time period.RESULTS: From a total of 66 patients tested, 9 patients were =75 years (14%). Grade I-IV morbidity was significantly higher in patients =75 years (78% vs 35%, p<0.05) as well as grade III-IV disease (56% vs 16%, p<0.05). There were no procedure-related mortality. In patients =75 years the median disease-free survival was 6 months (95% CI: 3.5-8.5 months) vs 24 months (95% CI: 10.5-37.5 months) in younger patients. The median overall survival in patients =75 years was 13 months (95% CI: 4.7-21.3), not having reached at time of analysis of the database in younger patients.CONCLUSIONS: Patients =75 years received no benefit in prognosis after interval cytoreduction with HIPEC and paid a high price in terms of postoperative morbidity. This age group should be excluded from this therapeutic procedure.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:24965986 |

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