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Peritoneal Carcinomatosis of Rare Ovarian Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Multi-Institutional Cohort from PSOGI and BIG-RENAPE

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Ovarian cancer is the most common deadly cancer of gynecologic origin. Patients often are diagnosed at advanced stage with peritoneal metastasis. There are many rare histologies of ovarian cancer; some have outcomes worse than serous ovarian cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can be considered for patients with recurrence. This study was designed to assess the impact of CRS and HIPEC on survival of patient with peritoneal metastasis from rare ovarian malignancy.

Methods

A prospective, multicentric, international database was retrospectively searched to identify all patients with rare ovarian tumor (mucinous, clear cells, endometrioid, small cell hypercalcemic, and other) and peritoneal metastasis who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI) and BIG-RENAPE working group. The postoperative complications, long-term results, and principal prognostic factors were analyzed.

Results

The analysis included 210 patients with a median follow-up of 43.5 months. Median overall survival (OS) was 69.3 months, and the 5-year OS was 57.7%. For mucinous tumors, median OS and DFS were not reached at 5 years. For granulosa tumors, median overall survival was not reached at 5 years, and median DFS was 34.6 months. Teratoma or germinal tumor showed median overall survival and DFS that were not reached at 5 years. Differences in OS were not statistically significant between histologies (p = 0.383), whereas differences in DFS were (p < 0.001).

Conclusions

CRS and HIPEC may increases long-term survival in selected patients with peritoneal metastasis from rare ovarian tumors especially in mucinous, granulosa, or teratoma histological subtypes.

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Acknowledgment

The authors thank Peggy Jourdan-Enfer and Anaïs Poulet for their help with data collection.

Disclosure

The authors report no conflicts of interest relevant to this article.

Collaborators

The collaborators of the BIG-RENAPE Working Group include the following: J. Abba (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); C. Arvieux (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); J-M. Bereder (Department of Surgical Oncology, CHU L’Archet 2, Nice, France); D. Bouzard (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); C. Brigand (Department of Surgical Oncology, CHRU Hautepierre, Strasbourg, France); S. Carrère (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); C. Eveno (Department of Surgical Oncology, CHU Lariboisière, Paris, France); O. Facy (Department of Surgical Oncology, CHU Dijon, Dijon, France); G. Ferron (Department of Surgical Oncology, IUCT Oncopole, Toulouse, France); F. Guyon (Department of Surgical Oncology, Institut Bergonié, Bordeaux, France); R. Kianmanesh (Department of Surgical Oncology, CHU Robert Debré, Reims, France); R. Lo Dico (Department of Surgical Oncology, CHU Lariboisière, Paris, France); G. Lorimier (Department of Surgical Oncology, ICO-Paul Papin, Angers, France); F. Marchal (Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France); P. Mariani (Department of Surgical Oncology, Institut Curie, Paris, France); P. Meeus (Department of Surgical Oncology, Centre Léon Bérard, Lyon, France); S. Msika (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); P. Ortega-Deballon (Department of Surgical Oncology, CHU Dijon, Dijon, France); B. Paquette (Department of Digestive Surgery, Minjoz University Hospital, Besançon, France); N. Pirro (Department of Surgical Oncology, CHU La Timône, Marseille, France); M. Pocard (Department of Surgical Oncology, CHU Lariboisière, Paris, France); P. Rat (Department of Surgical Oncology, CHU Dijon, Dijon, France); O. Sgarbura (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); E. Thibaudeau (Department of Surgical Oncology, ICO–René Gauducheau, St Herblain, France); F. Zinzindohoue (Department of Surgical Oncology, Hôpital Européen Georges Pompidou, Paris, France).

The collaborators of the PSOGI Working Group included the following: S. A. Ahrendt (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); E. Akaishi (Department of Surgical Oncology, Centro de Oncologia Hospital Sirio Libanes, Sao Paulo, Brazil); A. Bhatt (Department of Surgical Oncology, Fortis Hospitals Limited, Bangalore, India); P. Cachin (Department of Surgery, Akademiska sjukhuset, Uppsala University Hospital, Uppasala, Sweden); W. Ceelen (Department of Gastrointestinal Surgery, Gent University Hospital, Ghent, Belgium); R. P. Edwards (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); M. P. Holtzman (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); D. Kecmanovic (Department of Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia); K. W. Lee (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); E. A. Levine (Department of Surgical Sciences-Oncology, Wake Forest Baptist Medical Center, Winston Salem, USA); S. Mehta (Division of Peritoneal Surface Oncology, Saifee Hospital, Mumbai, India); D. L. Morris (Department of Surgery, University of New South Wales, Sidney, Australia); P. K. Pande (Department of Surgical Oncology, BLK Superspeciality Hospital, New Delhi, India); P. Piso (Department of Surgery, University of Regensburg, Regensburg, Germany); S. O’Dwyer (Department of Colorectal Surgery, Christie Cancer Center, Manchester, United Kingdom); J. F. Pingpank (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); F. Rajan (Department of Surgical Oncology, Kovai Medical Centre, Coimbatore, India); B. Rau (Department of Surgical Oncology, Charite Campus Mitte University of Berlin, Berlin, Germany); J. Spiliotis (First Department of Surgical Oncology, Metaxa Cancer Memorial Hospital, Piraeus, Greece); P. Sugarbaker (Department of Surgical Oncology, Washington Hospital Center, United States); M. Teo (Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore); R. Yarema (Department of Oncology and Medical Radiology Danylo Halytsky Lviv National Medical University, Lviv, Ukraine); Y. Yonemura (Department of Surgical Oncology, Organization to Support Peritoneal Dissemination Treatment, Osaka, Japan); H. J. Zeh (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA).

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    Frédéric Mercier MD, MSc, Naoual Bakrin MD, PhD & Olivier Glehen MD, PhD

  2. EMR 3738, Lyon 1 University, Lyon, France

    Naoual Bakrin MD, PhD, Laurent Villeneuve PhD & Olivier Glehen MD, PhD

  3. Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    David L. Bartlett MD

  4. Department of Surgical Oncology, Gustave Roussy, Villejuif Cedex, France

    Diane Goere MD

  5. Department of Surgery, Institut Du Cancer de Montpellier, Montpellier, France

    François Quenet MD

  6. Department of Surgical Oncology, ICO René Gauducheau Cancer Center, Saint-Herblain, France

    Frédéric Dumont MD

  7. Department of Digestive Surgery, Minjoz University Hospital, Besançon, France

    Bruno Heyd MD, PhD

  8. Department of General Surgery, St Etienne University Hospital, Saint-Étienne, France

    Karine Abboud MD

  9. Unité de Recherche Clinique, Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Lyon, France

    Christelle Marolho MSc & Laurent Villeneuve PhD

Authors
  1. Frédéric Mercier MD, MSc
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  2. Naoual Bakrin MD, PhD
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  3. David L. Bartlett MD
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  4. Diane Goere MD
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  5. François Quenet MD
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  6. Frédéric Dumont MD
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  7. Bruno Heyd MD, PhD
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  8. Karine Abboud MD
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  9. Christelle Marolho MSc
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  10. Laurent Villeneuve PhD
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  11. Olivier Glehen MD, PhD
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Consortia

the PSOGI Working Group

  • S. A. Ahrendt
  • , E. Akaishi
  • , A. Bhatt
  • , P. Cachin
  • , W. Ceelen
  • , R. P. Edwards
  • , M. P. Holtzman
  • , D. Kecmanovic
  • , K. W. Lee
  • , E. A. Levine
  • , S. Mehta
  • , D. L. Morris
  • , P. K. Pande
  • , P. Piso
  • , S. O’Dwyer
  • , J. F. Pingpank
  • , F. Rajan
  • , B. Rau
  • , J. Spiliotis
  • , P. Sugarbaker
  • , M. Teo
  • , R. Yarema
  • , Y. Yonemura
  •  & H. J. Zeh

the BIG-RENAPE Working Group

  • J. Abba
  • , C. Arvieux
  • , J-M. Bereder
  • , D. Bouzard
  • , C. Brigand
  • , S. Carrère
  • , C. Eveno
  • , O. Facy
  • , G. Ferron
  • , F. Guyon
  • , R. Kianmanesh
  • , R. Lo Dico
  • , G. Lorimier
  • , F. Marchal
  • , P. Mariani
  • , P. Meeus
  • , S. Msika
  • , P. Ortega-Deballon
  • , B. Paquette
  • , N. Pirro
  • , M. Pocard
  • , P. Rat
  • , O. Sgarbura
  • , E. Thibaudeau
  •  & F. Zinzindohoue

Corresponding author

Correspondence to Frédéric Mercier MD, MSc.

Additional information

Collaborators from PSOGI and BIG-RENAPE Working Groups are listed at the end of the manuscript (in the Acknowledgements).

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Mercier, F., Bakrin, N., Bartlett, D.L. et al. Peritoneal Carcinomatosis of Rare Ovarian Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Multi-Institutional Cohort from PSOGI and BIG-RENAPE. Ann Surg Oncol 25, 1668–1675 (2018). https://doi.org/10.1245/s10434-018-6464-z

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  • DOI: https://doi.org/10.1245/s10434-018-6464-z

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