{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:09:07Z","timestamp":1753182547547,"version":"3.40.5"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Internal Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["International Journal of Surgical Oncology"],"published-print":{"date-parts":[[2020,12,16]]},"abstract":"<jats:p>Background. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS\/HIPEC) after neoadjuvant chemotherapy (NACT) showed promise as initial treatment for stage IIIC (SIII) epithelial ovarian cancer (EOC); however, stage IV (SIV) outcomes are rarely reported. We assessed our experience and outcomes treating newly diagnosed SIV EOC with NACT plus CRS\/HIPEC compared to SIII patients. Methods. Advanced EOC from 2015\u20132018 managed with NACT (carboplatin\/paclitaxel) due to unresectable disease or poor performance status followed by interval CRS\/HIPEC were reviewed. Perioperative factors were assessed. Overall survival (OS) and progression-free survival (PFS) were analyzed by stage. Results. Twenty-seven FIGO stage IIIC (n\u2009=\u200912) and IV (n\u2009=\u200915) patients were reviewed. Median NACT cycles were 3 and 4, respectively. Post-NACT omental caking, ascites, and pleural effusions decreased\/resolved in 91%, 91%, and 100% of SIII and 85%, 92%, and 71% of SIV. SIII\/SIV median PCI was 21 and 20 obtaining 92% and 100% complete cytoreduction (\u22640.25\u2009cm), respectively. Median organ resections were 6 and 7, respectively. Grade III\/IV surgical complications were 0% SIII and 23% SIV, without hospital mortality. Median time to adjuvant chemotherapy was 53 and 74 days, respectively (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.007<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>). SIII OS at 1 and 2 years was 100% and 83% and 87% and 76% in SIV (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.269<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). SIII 1-year PFS was 54%; median PFS: 12 months. SIV 1- and 2- year PFS was 47% and 23%; median PFS: 12 months (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>p<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.944<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). Conclusion. Outcomes in select initially diagnosed and unresectable SIV EOC are similar to SIII after NACT plus CRS\/HIPEC. SIV EOC may benefit from CRS\/HIPEC, and further studies should explore this treatment approach.<\/jats:p>","DOI":"10.1155\/2020\/1467403","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T16:08:44Z","timestamp":1608221324000},"page":"1-14","source":"Crossref","is-referenced-by-count":3,"title":["Critical Analysis of Stage IV Epithelial Ovarian Cancer Patients after Treatment with Neoadjuvant Chemotherapy followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS\/HIPEC)"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6125-3170","authenticated-orcid":true,"given":"Carlos A.","family":"Munoz-Zuluaga","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4132-9489","authenticated-orcid":true,"given":"Armando","family":"Sardi","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2641-1564","authenticated-orcid":true,"given":"Michelle","family":"Sittig","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6151-5660","authenticated-orcid":true,"given":"Vadim","family":"Gushchin","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary C.","family":"King","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6337-5278","authenticated-orcid":true,"given":"Carol","family":"Nieroda","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1560-9172","authenticated-orcid":true,"given":"Felipe","family":"Lopez-Ramirez","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The Institute for Cancer Care at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0881-3236","authenticated-orcid":true,"given":"Teresa P.","family":"Diaz-Montes","sequence":"additional","affiliation":[{"name":"The Lya Segall Ovarian Cancer Institute at Mercy Medical Center, Baltimore, Maryland 21202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","volume-title":"AJCC Cancer Staging Manual","author":"L. 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