Publicaciones científicas

Intraperitoneal Hyperthermic Chemotherapy After Cytoreduction in Patients With Peritoneal Metastases From Endometrial Cancer. The Next Frontier?

15-jun-2020 | Revista: Surgical Oncology

Álvaro Navarro-Barrios (1), José Gil-Martínez (1), Isabel Ramos-Bernardo (2), Pedro Barrios (2), Cristóbal Muñoz-Casares (3), Juan Torres-Melero(4) , Fernando Pereira (5), Israel Manzanedo (5 , Álvaro Arjona (6), Fernando Martínez-Regueira (7), Pedro Antonio Cascales-Campos (8)

(1) Hospital Clínico Universitario Virgen de la Arrixaca-Instituto Murciano de Investigación Biosanitaria (IMIB), Servicio de Cirugía General y del Aparato Digestivo, Spain.
(2) Hospital de Sant Joan Despí Moisès Broggi, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(3) Hospital Universitario Virgen del Rocío, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(4) Hospital Universitario Torrecárdenas, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(5) Hospital Universitario de Fuenlabrada, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(6) Hospital Universitario Reina Sofía de Córdoba, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(7) Clínica Universidad de Navarra, Servicio de Cirugía General y del Aparato Digestivo, Spain.
(8) Hospital Clínico Universitario Virgen de la Arrixaca-Instituto Murciano de Investigación Biosanitaria (IMIB), Servicio de Cirugía General y del Aparato Digestivo, Spain.


Background: Endometrial cancer is the most common malignancy of the female genital tract. For cancers detected at an advanced stage or intraperitoneal relapse, the prognosis is poor. Optimal cytoreductive surgery (CRS) is the most accepted treatment; however, patients with advanced intraperitoneal disease might benefit from hyperthermic intraoperative peritoneal chemotherapy (HIPEC). The aim of this study was to analyze recurrence-free survival (RFS) after CRS and HIPEC in a large series of patients with peritoneal metastases from endometrial cancer.

Methods: Patients with a diagnosis of endometrial cancer with primary or recurrent peritoneal dissemination were included. All patients underwent CRS plus HIPEC. Data were prospectively collected in the Spanish Group of Peritoneal Oncological Surgery (GECOP) database.

Results: Forty-three patients with endometrial cancer and peritoneal metastasis were included. Fifteen patients (35%) were diagnosed with G3 endometrioid carcinomas and 28 (65%) with other non-endometroid histologies. A completeness of cytoreduction score of CC-0 was achieved in 41 patients (95%). RFS at 5 years was 23%, being factors related to worse RFS: treatment with preoperative chemotherapy (p = 0.027), resection of more than three peritoneal areas (p = 0.010), cytoreduction of the upper abdominal space (p = 0.023), HIPEC treatment with paclitaxel (p = 0.013), and the presence of metastatic lymph nodes (p = 0.029).

Conclusions: Better RFS rates after CRS and HIPEC were observed for patients with the following characteristics: cytoreductive surgery without preoperative chemotherapy, complete surgery performed with limited surgical maneuvers, treated with cisplatin, and no lymph node metastases.

Synopsis: Endometrial cancer has a poor prognosis when diagnosed at advance stage. Patients with intraperitoneal metastases from endometrial cancer may benefit from CRS plus HIPEC with improvement in the recurrence-free survival results.

CITA DEL ARTÍCULO  Surg Oncol . 2020 Jun;33:19-23. doi: 10.1016/j.suronc.2019.12.002. Epub 2019 Dec 31.

SOLICITE