Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for treatment of ovarian cancer

Abstract

Hyperthermic intraperitoneal chemotherapy (HIPEC), a strategy combining maximal cytoreductive surgery and maximal regional chemotherapy, has been applied to treat ovarian cancer resulting in long-term survival rates in selected patients. However, the status of HIPEC in ovarian cancer remains an experimental procedure, given the many variables among the data and trials reviewed, to enable us to derive strong conclusions about its role from this overview. In this review we discuss treatment with HIPEC in patients with ovarian cancer and future prospective of its use in clinical setting. HIPEC is an effective tool in the treatment of selected patients with peritoneal carcinomatosis from ovarian cancer. Unfortunately, due to the lack of randomised trials, the evidence of HIPEC is very limited. Future randomised studies are awaited to define the role and clinical impact of HIPEC in ovarian cancer.

Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer

“…It is difficult to differentiate the surgical complications associated with cytoreductive surgery from those associated with HIPEC. Common complications include ileus, anastomotic leaks, bowel perforations, fistulas, abscesses, sepsis, bleeding, and wound infections/dehiscences [40]. The OS and PFS rates were similar to those reported in the OCEANS, DESKTOP, and CALYPSO trials; however, given the differences in the trials, direct head to head comparison is not appropriate [22, 41–43].…”

“…Morbidity consistently ranged between 12% and 30%. The complications most frequently associated with HIPEC were hematologic toxicities from the transient bone marrow suppression and renal toxicity [40]. It is difficult to differentiate the surgical complications associated with cytoreductive surgery from those associated with HIPEC.…”

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in ovarian and gastrointestinal peritoneal carcinomatosis: results from a 7-year experience

“…Furthermore recently Sugarbaker et al underline the importance to treat previous PC from hepatic lesions because the increase in survival is worst in patients with PC that is much less controllable than hepatic metastasis (26). CRS + HIPEC in OC have been applied for many years to treat PC that occur in almost 70% of women (27). Moreover in about 50-75% of patients a persistent or recurrent disease can occur.…”

Simple Trans-Platinum Complex Bearing 3-Aminoflavone Ligand Could Be a Useful Drug: Structure-Activity Relationship of Platinum Complex in Comparison with Cisplatin

“…The HIPEC procedure is used several anticancer drugs: doxorubicin, cisplatin, carboplatin, mitomycin C [24]. For ovarian cancer, the HIPEC procedure is experimental because it doesn't randomized trials were conducted.…”