Utilization of intraperitoneal chemotherapy for optimally cytoreduced advanced stage epithelial ovarian cancer: A 10-year single institution experience with a racially diverse urban population

Objectives The goal of our study was to define utilization and clinical results of intraperitoneal (IV/IP) compared to intravenous (IV) chemotherapy in a racially and ethnically diverse population with optimally debulked advanced stage epithelial ovarian cancer. Methods After IRB approval, all patients diagnosed with epithelial ovarian cancer that underwent primary cytoreductive surgery at our institution from 2005 to 2016 were identified. Death was verified by the National Social Security Death Index. Patients who received at least one IV/IP cycle were analyzed in the IV/IP cohort. Kaplan-Meier and Cox proportional hazards models were performed. Results 96 patients with advanced stage optimally cytoreduced epithelial ovarian cancer (median follow up 33 months) were identified. 51% and 49% of patients received IV/IP and IV chemotherapy, respectively. 27%, 22%, and 39% of patients were of white, black, and other race. Compared with IV chemotherapy only, IV/IP chemotherapy was associated with longer OS (log rank < 0.002) and IV/IP chemotherapy versus IV chemotherapy alone was associated with a lower risk of death (HR = 0.31, 95% CI 0.16–0.62, P < 0.001). The median overall survival for the IV/IP and IV groups was 76 months (95% CI 62 - not estimated) and 38 months (95% CI 30–55), respectively. There was a trend toward higher risk of death for patients who completed fewer than 6 cycles of IV/IP chemotherapy compared to women who completed 6 IV/IP cycles (HR = 3.2, 95% CI 0.98–9.27 (P = 0.05). No differences in patient or tumor characteristics were identified between these two groups of patients. Conclusions In our racially diverse urban patients, 50% of patients received IV/IP chemotherapy and it was associated with improved overall survival compared to IV chemotherapy alone. Further investigation is needed to identify barriers to use of IV/IP chemotherapy.