Cytoreductive Surgery and Intraperitoneal Chemo-hyperthermia for Chemo-resistant and Recurrent Advanced Epithelial Ovarian Cancer: Prospective Study of 81 Patients

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2007 Jul 17

PMID 17629740

Citations 40

Authors

Eddy Cotte

Olivier Glehen

Faheez Mohamed

Franck Lamy

Claire Falandry

Francois Golfier

Francois Noel Gilly

Affiliations

Soon will be listed here.

Abstract

Purpose: There is no standardized treatment for patients with chemo-resistant or recurrent advanced ovarian cancer. Locoregional treatments combining cytoreductive surgery and intraperitoneal chemohyperthermia (HIPEC) may improve survival for locoregional disease.

Patients And Methods: A prospective single center study of 81 patients with recurrent or chemo-resistant peritoneal carcinomatosis from ovarian cancer was performed. Patients were treated by maximal cytoreductive surgery combined with HIPEC (with cisplatinum at 20 mg/m(2)/L). A total of 47 patients were included for their third, fourth, fifth, sixth, or seventh surgical look. Altogether, 54 patients presented with extensive carcinomatosis (malignant nodules of >5 mm).

Results: Complete macroscopic resection (CCR-0) was achieved in 45 patients. Mortality and morbidity rates were 2.5% and 13.6%, respectively. With a median follow-up of 47.1 months, the overall and disease-free median survivals were 28.4 and 19.2 months, respectively. Carcinomatosis extent and completeness of cytoreduction (p = 0.02 and p <0.001, respectively) were identified as independent prognostic factors. For CCR-0 patients, overall and disease-free survivals were 54.9 and 26.9 months, respectively.

Conclusion: Salvage therapy combining optimal cytoreductive surgery and HIPEC may achieve long-term survival in selected patients with recurrent or chemo-resistant ovarian cancer. This strategy may be most effective in patients with limited carcinomatosis or when cytoreductive surgery provides sufficient downstaging.

Citing Articles

Prognosis Following Surgery for Recurrent Ovarian Cancer and Diagnostic Criteria Predictive of Cytoreduction Success: A Systematic Review and Meta-Analysis.

Gaba F, Blyuss O, Chandrasekaran D, Bizzarri N, Refky B, Barton D Diagnostics (Basel). 2023; 13(22).

PMID: 37998621 PMC: 10670762. DOI: 10.3390/diagnostics13223484.

Hyperthermic intraperitoneal chemotherapy (HIPEC) for the management of primary advanced and recurrent ovarian cancer: a systematic review and meta-analysis of randomized trials.

Filis P, Mauri D, Markozannes G, Tolia M, Filis N, Tsilidis K ESMO Open. 2022; 7(5):100586.

PMID: 36116421 PMC: 9588894. DOI: 10.1016/j.esmoop.2022.100586.

Cytoreductive Surgery (CRS) Combined With Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Platinum-Sensitive Recurrence Epithelial Ovarian Cancer With HRR Mutation: A Phase III Randomized Clinical Trial.

Qi Y, Zhang Y, Shi Y, Yao S, Dai M, Cai H Technol Cancer Res Treat. 2022; 21:15330338221104565.

PMID: 35929135 PMC: 9358559. DOI: 10.1177/15330338221104565.

Current Medical Care Situation of Patients in Germany Undergoing Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC).

Horvath P, Yurttas C, Baur I, Steidle C, Reymond M, Girotti P Cancers (Basel). 2022; 14(6).

PMID: 35326595 PMC: 8946267. DOI: 10.3390/cancers14061443.

Limitations of laparoscopy to assess the peritoneal cancer index and eligibility for cytoreductive surgery with HIPEC in peritoneal metastasis.

Yurttas C, Uberruck L, Nadiradze G, Konigsrainer A, Horvath P Langenbecks Arch Surg. 2022; 407(4):1667-1675.

PMID: 35112142 PMC: 8809494. DOI: 10.1007/s00423-022-02455-2.

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