Timing is everything: intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer

Jessica Lee, John P. Curtin, Franco M. Muggia, Bhavana Pothuri, Leslie R. Boyd, Stephanie V. Blank

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods: Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan–Meier method and compared with log-rank tests. Results: Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001). Conclusions: Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.

Original languageEnglish (US)
Pages (from-to)55-63
Number of pages9
JournalCancer Chemotherapy and Pharmacology
Volume82
Issue number1
DOIs
StatePublished - Jul 1 2018
Externally publishedYes

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Chemotherapy
Ovarian Neoplasms
Surgery
Drug Therapy
Survival
Disease-Free Survival

Keywords

  • Intraperitoneal chemotherapy
  • Intravenous chemotherapy
  • Neoadjuvant chemotherapy
  • Ovarian cancer
  • Platinum chemotherapy
  • Primary debulking surgery

ASJC Scopus subject areas

  • Oncology
  • Toxicology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

Cite this

Timing is everything : intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer. / Lee, Jessica; Curtin, John P.; Muggia, Franco M.; Pothuri, Bhavana; Boyd, Leslie R.; Blank, Stephanie V.

In: Cancer Chemotherapy and Pharmacology, Vol. 82, No. 1, 01.07.2018, p. 55-63.

Research output: Contribution to journalArticle

Lee, Jessica ; Curtin, John P. ; Muggia, Franco M. ; Pothuri, Bhavana ; Boyd, Leslie R. ; Blank, Stephanie V. / Timing is everything : intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer. In: Cancer Chemotherapy and Pharmacology. 2018 ; Vol. 82, No. 1. pp. 55-63.
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abstract = "Purpose: To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods: Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan–Meier method and compared with log-rank tests. Results: Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6{\%}) received IP therapy; and 24 patients (36.3{\%}) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4{\%}) received IP and 56 patients (37.6{\%}) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001). Conclusions: Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.",
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T2 - intraperitoneal chemotherapy after primary or interval debulking surgery for advanced ovarian cancer

AU - Lee, Jessica

AU - Curtin, John P.

AU - Muggia, Franco M.

AU - Pothuri, Bhavana

AU - Boyd, Leslie R.

AU - Blank, Stephanie V.

PY - 2018/7/1

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N2 - Purpose: To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods: Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan–Meier method and compared with log-rank tests. Results: Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001). Conclusions: Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.

AB - Purpose: To evaluate the outcomes of intraperitoneal chemotherapy (IP) compared with those of intravenous chemotherapy (IV) in patients with advanced ovarian cancer after neoadjuvant chemotherapy (NACT) and interval debulking surgery (IDS) or primary debulking surgery (PDS). Methods: Patients with advanced epithelial ovarian carcinoma treated with PDS or NACT and IDS from 2006 to 2015 were identified. Comparative statistics were used to evaluate covariates, and survival rates were calculated using the Kaplan–Meier method and compared with log-rank tests. Results: Sixty-six patients received NACT followed by IDS with residual disease of ≤ 1 cm; 42 of these patients (63.6%) received IP therapy; and 24 patients (36.3%) had IV therapy only after IDS. The median progression-free survival (PFS) was 16.0 months in the IP group and 13.5 months in the IV group (p = 0.13). The estimated median overall survival (OS) was 64.0 months with IP and 50.0 months with IV (p = 0.44). During the same study period, 149 patients underwent optimal PDS after which 93 patients (62.4%) received IP and 56 patients (37.6%) were given IV chemotherapy. Patients after IP demonstrated improved survival outcomes when compared to patients after IV therapy. The median PFS was 28.0 months after IP and 16.5 months after IV (p = 0.0006), and the median OS was not reached for IP and 50.0 months after IV (p < 0.0001). Conclusions: Although IP chemotherapy after PDS is associated with improved survival, IP therapy after NACT and IDS, despite high rates of completion, may not have the same degree of survival advantage over IV therapy.

KW - Intraperitoneal chemotherapy

KW - Intravenous chemotherapy

KW - Neoadjuvant chemotherapy

KW - Ovarian cancer

KW - Platinum chemotherapy

KW - Primary debulking surgery

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