Table 5. Retrospective observational studies focus on intraperitoneal chemotherapy for recurrent EOC.
| First authors (ref.) | Year | Case-control or cohort | Primitive/Recurrence | FIGO (Inclusion of persistent EOC§?) | IP therapy technique | No. of pts | Treatment and Chemotherapy regimen^ | Platinum-Sensitive pts | CC0-1 n (%) | Median OS (months) [5y-OS%] | Median DFS or PFS° (months) [5y-DFS%] | Morbidity (3-4 grade/severe) % | Mortality % | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HIPEC | |||||||||||||||
| Amira (33) | 2018 | Ca-Co | rEOC | – (no) | HIPEC | 15 ca | CRS + HIPEC with Cis 100 mg/m2 | 100% Platinum-S | – | 36 | 6 | – | 13.3 | ||
| 20 co | Carboplatin + Taxol EV | 38 | 5 | ||||||||||||
| Arjona-Sanchez (34) | 2018 | Cohort | rEOC | IIIc-IV with down-staging after NACT (no) | HIPEC | 100 | NACT with IV Carboplatin + Taxol (or Doxo for platinum-resistant) + HIPEC with Paclitaxel 60 mg/m2 | 98% Platinum-S, 2% Platinum-R | CC-0: 92 (92) CC-1: 8 (8) |
48.2 [64] | CC-0: 49.3 [59], CC-1: 31.6 [35]. Negative lymph nodes: 49.3 [58]; Positive lymph nodes: 42.6 [46] | – | 16 | 0 | |
| Baiocchi (35) | 2016 | Ca-Co | rEOC | I-IV (no) | HIPEC | 50 ca | CRS + HIPEC with MMC 10 mg/m2 + Cis (50 mg/m2): 15 pts; Cis (50 mg/m2) + Doxo: 8 pts; Oxa: 3 pts; Cis: 3 pts | 100% Platinum-S | CC-0: 60 (77.9) CC-1: 9 (11.7) CC-2,3: 8 (10.4) |
58.3 [49.7] | 15.8 | 69.0 (34.5) | 0 | ||
| 29 co | CRS | 59.3 [49.5] | 18.6 | 42.6 (10.6) | 4 | ||||||||||
| Bakrin (36) | 2012 | Cohort | rEOC | – (yes) | HIPEC | 246 | Platinum-based CT before surgery + CRS + HIPEC with Cis alone or with Doxo/Mito | Platinum-S 184 (74.8), Platinum-R 62 (25.2) | CC-0,1: 247 (92.2), CC-2,3: 21 (7.8) | 48.9 [35] | Platinum-R:48, Platinum-S: 52 | 12.8 [9] | (11.6) | 0.37 | |
| Carrabin (37) | 2010 | Cohort | rEOC | IIIC (yes) | HIPEC | 18 (8 recur-rent, 10 persistent) | CRS+HIPEC with Oxa 460 mg/m2 | Platinum-S 7 (87.5), Platinum-R: 1 (12.5) | CC-0: 16 (88.9), CC-1: 2 (11.1) | Not reached, 2y-OS 92%, 3y-OS 83% |
11.3 | (55.6) | 0 | ||
| Cascales-Campos (38) | 2015 | Ca-Co | rEOC | I-IV (no) | HIPEC | Ca 32 | Pre-op Platinum + Taxanes EV if unresectable + CRS+HIPEC with Paclitaxel 60 mg/m2 | 100% Platinum-S | CC-0 54 (100) | – | 3y DFS: 45 | 28 (21) | 0 | ||
| Co 22 | Pre-op Platinum + Taxanes EV if unresectable + CRS | 3y DFS: 23 | 23 (14) | ||||||||||||
| Chatzigeorgiou (39) | 2003 | Cohort | rEOC | – | HIPEC | 20 | CRS+HIPEC with Cis 50-70 mg/m2 | 30% Platinum-S, 70% Platinum-R | Residual tumor (RT). <1.5 cm: 12 (60), >1.5 cm: 8 (40) | RT <1.5 cm: 29, RT >1.5 cm: 7. Platinum-S: 27, Platinum-R: 9 | – | 15 | 5 | ||
| Cianci (40) | 2019 | Cohort | rEOC (previous CRS+HIPEC) | – (no) | Tertiary HIPEC | 12 | Tertiary CRS + HIPEC with Oxa 360 mg/m2 or Cis 75 mg/m2 | 100% Platinum-S | 100% RT=0 | Mean OS 99 | 28 | 24.9 (8.3) | 0 | ||
| Classe (41) | 2015 | Cohort | rEOC (first relapse) | (yes) | HIPEC | 314 | (Ev. second-line IV CT) + CRS + HIPEC with Cis | Platinum-R 52.9% Platinum-S 47.1% | CC-0: 248 (79) CC-1.2: 66 (21) |
[38] | Platinum-S: 42 Platinum-R: 51 CC-0: 54 CC-1.2: 36 | [14] | Platinum-S: 13 Platinum-R: 14 CC-0: 15 CC-1,2: 10 |
(30.9) | 1 |
| Cotte (42) | 2007 | Cohort | rEOC | (yes) | HIPEC | Persistence of disease + Platinum-R recurrence 16 | CRS + HIPEC with Cis 20 mg/m2/L | Platinum-R 19.8% Platinum-S 80.2% |
CC-0: 45 (55.5) CC-1: 20 (24.7) CC-2: 16 (19.8) |
24.3 | PCI<12: 37.6, PCI>12: 13.1; CC-0: 54.9, CC-1: 17.0, CC-2: 5.1 | 8.0 | PCI<12: 12.8, PCI>12: 2.4; CC-0: 47.8 | (13.6) | 2.5 |
| Platinum-S recurrence 65 | 28.4 | 8.5 | |||||||||||||
| Delotte (43) | 2014 | Cohort | rEOC >70 y | – (no) | HIPEC | 15 | CRS+HIPEC with Cis 50 mg/m2 + Doxo 15 mg/m2 | – | CC-0: 9 (60), CC-1: 6 (40) |
35 | 15.6 | (20) | 0 | ||
| Deraco (44) | 2001 | Cohort | rEOC | I-IV (yes) | HIPEC | 27 | CRS+HIPEC with Cis 25 mg/m2/L + MMC 3.3 mg/m2/L | – | CC-0: 15 (55), CC-1: 4 (15), CC-2: 3 (11), CC-3: 5 (19) | [2yOS: 55%] | CC-0,1: 20.3 [2yOS 77%], CC-2,3: 4.3 [2yOS 0%] | 21.8 [2yDFS: 21%] | 11 | 4 | |
| Deraco (45) | 2012 | Cohort | rEOC | I-IV (no) | HIPEC | 56 | CRS+HIPEC with Cis 42 mg/L + Doxo 15 mg/L or Cis 25 mg/L/m2 + MMC 3.3 mg/L/m2 | Platinum-S 58.9% Platinum-R 23.1% |
CC-0: 46 (83.9) CC-1: 7 (12.5) CC-2: 1 (1.8) |
25.7 [23] | 10.8 [7] | (26.3) | 5.3 | ||
| Fagotti (46) | 2009 | Cohort | rEOC | I-IV (yes) | HIPEC | 25 | CRS+HIPEC with Oxa 460 mg/m2 + post-op IV Oxa + Docetaxel | Platinum-S 100% | CC-0: 23 (92) CC-1: 2 (8) |
– | 10 | (28) | 0 | ||
| Fagotti (47) | 2012 | Ca-Co | rEOC | I-IV (yes) | HIPEC | 30 Ca | CRS+HIPEC with Oxa 469 mg/m2 + post-op IV platinum CT | Platinum-S 100% | CC-0: 29 (96.7) CC-1: 1 (3.3) |
[68.4] | 26 | (34.8) | 0 | ||
| 37 Co | CRS+IV CT (35%) or IV CT (65%) | – | [42.7] | 15 | |||||||||||
| Fagotti (48) | 2014 | Cohort | rEOC (single nodule) | Single nodule (no) | Laparoscopic HIPEC | 10 | Laparoscopic/robotic CRS+HIPEC with Oxa 469 mg/m2 or Cis 75 mg/m2 + post-op IV carboplatin-paclitaxel CT | Platinum-S 100% | CC-0: 100% | – | – | 10 | 0 | ||
| Fahim (49) | 2018 | Cohort | rEOC | (no) | HIPEC | 9 | CRS+HIPEC with Cis 200 mg/m2 | Platinum-S 100% | – | 42 | Not reached | – | 22.2 | ||
| Furet (50) | 2013 | Cohort | rEOC | – | HIPEC | 17 | CRS+HIPEC with Oxa 460 mg/m2 + IV 5FU 400 mg/m2 or Carbo 400-1200 mg/m2 | – | CC-0: 16 (94) | mean OS: 30.5 | 11.9 | 47 (17.6) | 0 | ||
| Gomez-Ruiz (51) | 2019 | Cohort | rEOC | I-IV (–) | HIPEC | 64 | CRS+HIPEC with Paclitaxel 60 mg/m2 or Cis 75 mg/m2 | Platinum-S 100% | CC-0: 57 (89) CC-1: 7 (11) |
– | 17 [30] | – | – | ||
| Helm (52) | 2007 | Cohort | rEOC | IIIC-IV | HIPEC | 18 | CRS+HIPEC with Cis 100 mg/m2 or MMC 40 mg | – | CC-0: 11 (61.1) CC-1: 6 (33.4) CC-2: 1 (5.5) |
31, RT<2 mm: 31, RT>2 mm: 8 | 10 | 100 (72) | 5.5 | ||
| Konigsrainer (53) | 2011 | Cohort | rEOC | IIIb-IV (–) | HIPEC | 31 | CRS+HIPEC with Cis 50mg/m2 | – | CC-0: 20 (65) CC-1: 8 (25) CC-2: 3 (10) |
[3y-OS 50%] | [3y-DFS 15%] | 23 | 0 | ||
| Konigsrainer (54) | 2014 | Cohort | rEOC | I-IV (–) | HIPEC | CC-0,1: 62 | CRS+HIPEC with Cis 50 mg/m2 | Platinum-R 13% Platinum-S 87% |
CC-0: 47 (52) CC-1: 15 (17) |
35 | – | 45 (26) | 0 | ||
| CC-2,3: 28 | CC-2: 5 (6) CC-3: 23 (26) |
14 | 36 (11) | 0 | |||||||||||
| Le Brun (55) | 2014 | Ca-Co | rEOC | I-IV (yes) | HIPEC | Ca 23 | CRS+HIPEC with Cis, Eloxatin, MMC | Platinum-S 100% | CC-0: 42 (100) | [4y-OS 75.6] | – | – | – | ||
| Co 19 | CRS | [4y-OS 19.4] | |||||||||||||
| Marocco (56) | 2016 | Ca-Co | rEOC | I-IV (yes) | HIPEC | 16 | IV platinum-based CT | Platinum-S 100% | – | 35.6 | 13.2 | 0 (0) | 0 | ||
| 11 | CRS + IV platinum-based CT | CC-0 100% | Not reached | 23 | 36 (0) | 0 | |||||||||
| 19 | IV platinum-based CT + CRS + HIPEC with Cis 100 mg/m2 + Doxo 15.2 mg/L | 51.5 | 19.9 | 32 (16) | 0 | ||||||||||
| Munoz-Casares (57) | 2009 | Ca-Co | rEOC | III | HIPEC | 14 Ca | CRS+HIPEC with Paclitaxel 60 mg/m2 + post-op IV CT | – | CC-0: 16 (61.5) CC-1: 10 (38.5) |
[57] [for CC-0 67] | Mean DFS 48 | 29 (14) | 0 | ||
| 12 Co | CRS + post-op IV CT | [17] [for CC-0 29] | Mean DFS 24 | 25 (25) | 0 | ||||||||||
| Petrillo (58) | 2016 | Cohort | rEOC | I-IV | HIPEC | 70 | CRS + HIPEC with Oxa 460 mg/m2 or Cis 75 mg/m2 | Platinum-S 100% | CC-0: 62 (88.6) CC-1: 8 (11.4) |
– | 27 | 35.7 (8.5) | 0 | ||
| Safra (59) | 2014 | Ca-Co | rEOC | I-II-III (no) | HIPEC | 26 | CRS + HIPEC Cis 50 mg/m2 + Doxo 15 mg/m2 or Paclitaxel 60 mg/m2 + Carbo or Cis 25 mg/L/m2 + MMC 3.3 mg/L/m2 | Platinum-S 100% | CC-0: 110 (100) | Not reached [79]; BRCA wt: 61.6; BRCA mut: 80.1 | 15, BRCA wt: 21.8, BRCA mut: 20.9 | – | – | ||
| 84 | IV CT with Carbo + Paclitaxel or Doxo or Gemcitabine or Topotecan | [45] BRCA wt: 47.7, BRCA mut: 71.6 | 6, BRCA wt: 12.1, BRCA mut: 12.6 | ||||||||||||
| Spiliotis (60) | 2019 | Ca-Co | rEOC | – (yes) | HIPEC | 80 with residual disease + 30 with recur-rent disease | CRS + HIPEC with + post-op IV CT | Platinum-S 100% | Residual disease: CC-0 (75) Recurrent disease: CC-0 (64) |
Residual disease: 38 Recurrent disease: 26 |
– | Residual disease: 18; Recurrent disease: 22 |
Residual disease: 2.5; Recurrent disease: 3.3 |
||
| 60 with residual disease + 20 with recur-rent disease | CRS + post-op IV CT | Residual disease: 23.8, Recurrent disease: 16 |
Residual disease: 7; Recurrent disease: 15 |
Residual disease: 1.3; Recurrent disease: 0 |
|||||||||||
| Van der Vange (61) | 2000 | Cohort | rEOC | – | HIPEC | 5 | CRS + HIPEC with Cis 50–70 mg/m2 | – | CC-0,1: 5 (100) | – | – | 60 | 0 | ||
| Vernaccini (62) | 2016 | Ca-Co | rEOC with PCI>20 | IIIB-IV (yes) | HIPEC | 9 Ca | CRS + HIPEC | – | CC-1 (57.1), CC-2 (42.9) | 3 months-OS 77.8%, 1 y-OS 55.6% |
– | – | – | ||
| 5 Co | CRS | 3 months-OS 60%, 6 months-OS 0% |
|||||||||||||
| Zivanovic (63) | 2014 | Ca-Co | rEOC | IIIB-IIIC-IV | HIPEC | 3 | CRS + HIPEC with Cis 60 mg/m2 | Platinum-S 100% | CC-0: 7 (58), CC-1: 1 (8), CC-2: 4 (34) | – | 13.6 | DLT 0 | 0 | ||
| 3 | CRS + HIPEC with Cis 80 mg/m2 | DLT 0 | 0 | ||||||||||||
| 6 | CRS + HIPEC with Cis 100 mg/m2 | DLT 16.7 | 0 | ||||||||||||
| Other intraperitoneal chemotherapy | |||||||||||||||
| Lu C (64) | 2015 | Propensity score | rEOC | I-IV (yes) | IP | 155 Ca | CRS + IP platinum-based CT | Platinum-S 216 (69.7); Platinum-R 94 (30.3) | RT=0: 77 (24.8); RT<1 cm: 86 (27.7); RT>1 cm: 147 (47.4) | – | Platinum-S: 9.8, Platinum-R: 4.9 |
– | – | ||
| 155 Co | CRS+IV CT | Platinum-S: 6.9, Platinum-R: 2.4 |
|||||||||||||
| Plaisant (65) | 2004 | Cohort | rEOC | IC-IV (yes) | IP | 9 persistent EOC | CRS + IP CT with Paclitaxel 175 mg/m2 | – | CC-0: 8 (61.5); CC-1: 2 (15.5); CC-2: 3 (23) | 25.5 | 8.5 | 11.7 | (92) | 7.7 | |
| 4 rEOC | 4.2 | ||||||||||||||
§EOC with sub-optimal cytoreduction at primary surgery and evidence of persistent peritoneal disease; Cis, Cisplatin; Doxo, Doxorubicin; MMC, Mitomycin C; Oxa, Oxaliplatin; Carbo, Carboplatin; Ca-Co, case-control; CT, Chemotherapy; rEOC, recurrent EOC; pEOC, primary EOC; cEOC, HIPEC for consolidation. NA, not available; DLT, dose limiting toxicity.