Cytoreductive surgery plus HIPEC for advanced epithelial ovarian cancer: Analysis from a multicentric national Indian HIPEC registry of 1,470 patients—An ISPSM Collaborative study.

Authors

S.P. Somashekhar

S.P. Somashekhar

Manipal Comprehensive Cancer Center, Bangalore, India

S.P. Somashekhar , S.V.S. Deo , Rupinder Sekhon , Subramanyeshwar Rao Thammineedi , Harit Chaturvedi , Ganesh M S , Rama Joshi , Kalpana Kothari , Amit Gandhi , Ashwin K. Rajgopal , M D Ray , R Rajagopalan Iyer , Hemanth G N , Rohit Kumar

Organizations

Manipal Comprehensive Cancer Center, Bangalore, India, Department of Surgical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India, Rajiv Gandhi Cancer Institute & Research Center, New Delhi, India, Basavatarakam Indo-American Cancer Hospital & Research Institute, Hyderabad, India, Max Cancer Center, New Delhi, India, Vydehi Institute Of Medical Sciences & Research Center, Bangalore, India, Fortis Memorial Research Institute, Gurugram, India, HCG Cancer Center, Ahmedabad, India, Zynnova Hospital, Mumbai, India, Manipal Comphrensive Cancer Center, Bangalore, India, All India Institute Of Medical Sciences, New Delhi, India

Research Funding

No funding received

Background: Improved long-term results can be achieved in advanced epithelial ovarian cancer (EOC) patients using optimal cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: Indian society of peritoneal surface malignancy (ISPSM) is a registered body which maintains prospective data of 26 centers across India who perform CRS –HIPEC. From February 2017 until January 2022, 1470 patients with advanced EOC were treated with CRS-HIPEC. He general practice patterns and the oncological outcomes in terms of progression free survival (PFS) and overall survival (OS) & post-operative morbidity and mortality is reported. Results: Upfront (n = 156), interval (n = 645) and recurrent (n = 669) cytoreductions were performed based on the timeline at presentation. Mean age 54.5±10.74, PCI 13. 6±5.2, duration of surgery 10.6±1.h hrs. 36.4% had total peritonectomy, 12.7% had multivisceral resection, 41.8%had bowel resections and stoma rate was 7.4%. 60.3% had semiopen HIPEC, 83.1% used cisplatin for HIPEC and 83.1 % had HIPEC for 90 minutes. Overall G3-G5 morbidity was 25.4% with major ones being post-operative intra-abdominal collection (21.8%), electrolyte imbalance (16.4%), pulmonary (16.4%) followed by hematological (12.7%). Surgical morbidity was more in upfront cytoreduction group compared to interval group (20% versus 13.5%) and recurrent group (20% versus 15%), respectively. The 30 day mortality was 3.8%. With a median follow-up of 46 months, median PFS was 33 months in primary (upfront plus interval) group and 16 months in recurrent cytoreduction group. Median OS was not achieved in both primary and recurrent groups (4 year OS rates: 60 and 55%, respectively). Conclusions: This prospective database provides a collation and audit of the management of advanced epithelial ovarian cancer with CRS HIPEC in multiple centers registered under ISPSM. In advanced EOC patients, CRS plus HIPEC offers potential benefits in PFS and OS rates, with acceptable rates of morbidity and mortality and can be practiced even in resource constrained setting.

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Biologic Correlates

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 5525)

DOI

10.1200/JCO.2022.40.16_suppl.5525

Abstract #

5525

Poster Bd #

404

Abstract Disclosures