Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC)
Table 2
CRS/HIPEC and postoperative characteristics by stage.
Characteristic
Total population (n = 27)
Stage III (n = 12)
Stage IV (n = 15)
value
CRS/HIPEC characteristics
Median time from NACT to CRS/HIPEC [IQR], days
40 [35–45]
41 [30–47]
40 [35–45]
0.757
Median PCI [IQR]
20 [12–27]
21 [10–29]
20 [13–26]
0.926
Extent of resections, median [IQR]
Organs resected
7 [5–8]
6 [5–8]
7 [6–8]
0.490
Visceral peritonectomies
2 [2-3]
2 [1–3]
2 [2-3]
0.409
Parietal peritonectomies
4 [3-4]
4 [3-4]
4 [3–5]
0.504
Pelvic mass, n (%)
24 (89)
9 (75)
15 (100)
0.075
Bowel anastomosis, n (%)
0
5 (19)
3 (25)
2 (13)
—
1
13 (48)
5 (42)
8 (53)
—
2
9 (33)
4 (33)
5 (33)
—
CC score, n (%)
CC-0 (no visible tumor)
22 (81)
8 (67)
14 (93)
—
CC-1 (tumor ≤0.25 cm)
4 (15)
3 (25)
1 (7)
—
CC-2 (tumor 0.25 cm–2.5 cm)
1 (4)
1 (8)
0 (0)
—
Median length of surgery [IQR], hours
8 [7–8]
8.3 [6.4–9.3]
8 [7–8.3]
0.482
Estimated blood loss [IQR], mL
500 [350–800]
425 [275–600]
600 [350–1000]
0.170
Transfusions, n (%)
Intraoperative
16 (59)
7 (58)
9 (60)
1.000
Postoperative
21 (78)
7 (58)
14 (93)
0.060
Median length of hospitalization [IQR], days
9 [7–11]
8 [6–9]
11 [8–12]
0.010
Tumor site, n (%)
Ovary
9 (33)
4 (33)
5 (33)
—
Fallopian tube
11 (41)
4 (33)
7 (47)
—
Primary peritoneal
7 (26)
4 (33)
3 (20)
—
Postoperative characteristics
Grade III/IV surgical complications, n (%)
3 (11)
0 (0)
3 (23)
—
Hematologic toxicity, n (%)
Anemia
Preoperative
22 (82)
10 (83)
11 (73)
0.662
Postoperative
27 (100)
12 (100)
15 (100)
—
Leukopenia
Preoperative
10 (37)
6 (50)
4 (27)
0.257
Postoperative
10 (37)
3 (25)
7 (47)
0.424
Thrombocytopenia
Preoperative
1 (4)
0 (0)
1 (7)
1.000
Postoperative
19 (70)
7 (58)
12 (80)
0.398
Median CA-125 post-CRS/HIPEC [IQR] (n), U/mL
13 [8.2–23.2]
17 [8.2–28.6] (10)
13 [7.3–21.9] (12)
0.767
Positive lymph nodes, n (%)
17/26 (65)
7/11 (63)
10 (67)
0.706
Patients with ASC, n (%)
21 (78)
11 (92)
10 (67)
0.182
Median time from CRS/HIPEC to ASC [IQR], days
57 [51–73]
53 [40–58]
74 [56–91]
0.007
Median CA-125 post-ASC [IQR] (n), U/mL
9.5 [7–13]
11 [7–18.2] (11)
9 [7.3–12.3] (8)
0.385
Recurrence, n (%)
21 (81)
9/11 (81)
12 (80)
0.236
Alive, n (%)
15 (55)
5 (42)
10 (67)
—
Median follow-up (95% CI), months
31 [22–40]
31 [23–39]
30 [14–46]
—
ASC: adjuvant systemic chemotherapy, CC: completeness of cytoreduction score, CI: confidence interval, CRS/HIPEC: cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, IQR: interquartile range, NACT: neoadjuvant chemotherapy.
