A guide to establishing a hyperthermic intraperitoneal chemotherapy program in gynecologic oncology

Efficacy of hyperthermic intraperitoneal chemotherapy and interval debulking surgery in women with advanced uterine serous carcinoma

“…Notably, randomized studies in women with OC have not demonstrated an increased risk of grade III or IV adverse events following IDS with HIPEC versus IDS alone ( van Driel et al, 2018 ). Furthermore, recently published retrospective studies have shown acceptable toxicity following CRS with HIPEC in women with advanced OC ( Chambers et al, 2020 , Chichura et al, 2021 , Chambers et al, 2021 , van Driel et al, 2018 , Spiliotis et al, 2015 , Lei et al, 2020 , Brind'Amour et al, 2021 , Navarro-Barrios et al, 2020 , Tempfer et al, 2019 , Díaz-Montes et al, 2018 , Spiliotis, 2018 ). Notably, in our series of women with advanced USC, HIPEC was overall well-tolerated with only one patient experiencing a severe complication, which was anastomotic failure following rectosigmoid resection with primary re-anastomosis.…”

“…Within this cohort, the diagnosis of USC was confirmed on final surgical pathology in patients believed to have a diagnosis of high-grade serous ovarian cancer initially, leading to subsequent mismatch repair (MMR) and HER2 testing. All IDS with HIPEC were performed as previously described ( Chambers et al, 2020 , Chichura et al, 2021 , Chambers et al, 2021 ). HIPEC chemotherapy regimen was cisplatin (100 mg/m 2 ) with or without paclitaxel (135–175 mg/m 2 ) administered in a normal saline perfusate at a goal temperature of 41-43C degrees for 90 min.…”

“…The poor prognosis of women with advanced USC regardless of treatment paradigm highlights the significant, unmet need to advance therapeutic options ( Holman et al, 2017 , Thomas et al, 2007 , Bogani et al, 2019 , Wilkinson-Ryan et al, 2015 , Chambers et al, 2021 , Bristow et al, 2001 , Rauh-Hain et al, 2010 , Goff et al, 1994 , Lee et al, 2014 ). HIPEC has been increasingly utilized to manage peritoneal-based malignancies, such as ovarian cancer (OC) ( Chambers et al, 2020 , Chichura et al, 2021 , Chambers et al, 2021 , van Driel et al, 2018 , Spiliotis et al, 2015 , Lei et al, 2020 ). In a phase III randomized trial by Van Driel et al of women with advanced OC, IDS with HIPEC significantly improved PFS and OS compared to IDS alone ( van Driel et al, 2018 ).…”

Perioperative outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in elderly women with epithelial ovarian cancer: analysis of a prospective registry

“…The primary gynecologic oncologist was responsible for the HIPEC protocol, including the chemotherapy regimen, based on provider preference or surgical factors, as previously described. 35 Data Collection Patient demographics were collected, including age, race, body mass index (kg/m 2 ), American Society of Anesthesiologists (ASA) score at HIPEC, and medical comorbidities, including hypertension, diabetes mellitus, and venous thromboembolic disease. Oncologic variables included stage, histology, disease status (primary treatment or recurrent platinum-sensitive disease), hereditary cancer syndromes, neoadjuvant chemotherapy regimen and dosing, and preoperative cancer antigen 125 (CA125).…”

“…[22][23][24][25][26][27][28][29][30][31] Recent studies have established a role for hyperthermic intraperitoneal chemotherapy (HIPEC) during cytoreductive surgery in women with ovarian cancer. [32][33][34][35][36] In a randomized trial of women treated with neoadjuvant chemotherapy and interval cytoreductive surgery, HIPEC improved progression-free survival and overall survival, without increasing toxicity. 36 However, the median age of patients who received HIPEC was 61 years, raising concerns about the safety and oncologic benefit in older women.…”