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Master Thesis

Facteurs prédictifs des carcinoses d'origine annexielle pour la réponse à la CHIP. Une étude rétrospective niçoise

Abstract : Introduction. The prognosis of ovarian cancer remains poor. One of the therapeutic weapon, the Hyperthermic Intra-Peritoneal Chimiotherapy (HIPEC), is still controversial. In order to understand it better, we have tried to show the impact on the prognosis of the peritoneal carcinomatosis of adnexal cancers treated by CRS (Cytoreductive Surgery) + HIPEC regarding some predictive factors. For that, our primary endpoint has been overall survival and secondary endpoints have been disease-free survival and morbidity.
Methods. 268 patients, divided in 4 groups (interval, platin-resistant, platin-intermediate, platin-sensitive), have been included in a monocentric retrospective cohort observational analytic study between 2001 and 2015.
Results. The statistically significant prognostic factors in multivariate analysis for overall survival have been the PCI (HR 1,11 IC95 [1,028-1,19], p=0,007) in the interval group ; the PCI (HR 1,05 IC95 [1,02-1,09], p=0,004) and the number of anterior chemotherapies (HR 1,28 IC95 [1,08-1,51], p=0,004) in the recurrence groups. Overall survival medians were significantly better with a lower PCI in recurrence groups (PCI [0-8] up to 59,3 months IC 95 [45,1-75,4], PCI [9-16] up to 47,8 months IC 95 [37,5-64,7] and PCI [17-26] up to 24,2 months IC 95 [18,3-41,5] (p=0,00046)) and with two lines of chemotherapy or less for the recurrence groups (≤2 lines up to 50,3 months IC 95 [40,9-64,6] and >2 lines up to 37,3 months IC 95 [30,1-53,4] (p = 0,0028)).
Conclusion. A better comprehension of the prognostic factors to HIPEC could improve the relevance of the indications. In our study, many factors were predictive of the response to HIPEC in overall survival, disease-free survival and complications. Other studies are needed to improve the indications of HIPEC in adnexal cancer.
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Master Thesis
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Submitted on : Wednesday, November 27, 2019 - 11:45:18 AM
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Émilie Roux. Facteurs prédictifs des carcinoses d'origine annexielle pour la réponse à la CHIP. Une étude rétrospective niçoise. Médecine humaine et pathologie. 2019. ⟨dumas-02382606⟩

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