Cytoreductive Surgery Followed by Intraperitoneal Hyperthermic Perfusion in the Treatment of Recurrent Epithelial Ovarian Cancer: A Phase II Clinical Study

Abstract

Our results suggest that cytoreductive surgery + intraperitoneal hyperthermic perfusion is a well-tolerated, feasible and promising alternative in the management of selected patients with recurrent ovarian cancer, but further randomized controlled studies are needed in order to confirm our findings.

Radical surgery‐peritonectomy and intraoperative intraperitoneal chemotherapy for the treatment of peritoneal carcinomatosis in recurrent or primary ovarian cancer

“…Kaplan-Meier's overall survival rates of 33 patients with peritoneal carcinomatosis from primary ovarian cancer and recurrent ovarian cancer after radical-peritonectomy and hypertermic intraoperative intraperitoneal chemotherapy. improve survival rates of patients with peritoneal carcinomatosis from ovarian cancer as Sugarbaker described [7,[12][13][14][15]. Nevertheless, still hasn't turned into the standard treatment and there are few institutions that develop radical surgery associated to peritonectomy procedures and HIIC.…”

Hyperthermic intraperitoneal chemotherapy with and without cytoreductive surgery for epithelial ovarian cancer

“…Studies with the most clearly definable results for recurrent/persistent disease report median overall survivals of 28.1, 31, 41.4, and 57 months, [55,63,67,68], overall 2-year survival 55% [60] and 60% [63], 3-year survival 37.5%, [61] 51%, [55] and 55% [66] and overall 5-year survival 15% [67]. Rufian reported 2-and 5-year survival of 75% for patients with recurrent disease 55 years of age [55].…”

“…The peri-operative mortality rate for CRS and HIPEC was 3.7% (8/236 cases) [50,[53][54][55]58,60,[62][63][64][65]67,68] compared with 1.4% (0-3.4%) out of 631 patients undergoing CRS for recurrent EOC [88]. Neither the risks nor risk/benefit ratio associated with HIPEC þ CRS versus CRS alone have been clearly defined.…”

“…Where postoperative morbidity information for CRS þ HIPEC in recurrent/persistent EOC is detailed in Table III [50,[53][54][55]58,60,[62][63][64][65]67,68] grade 3 or 4 hematologic toxicity was 4.7% (11/236) and raised creatinine, mainly associated with the use of cisplatin, was 3.4% (8/236). The rate of anastomotic leaks was 1.7% (4/236) and gastrointestinal perforations 2.5% (6/236).…”

“…Reported prognostic factors for survival in recurrent/persistent disease include the interval from diagnosis to HIPEC [60,68], the peritoneal cancer index (PCI) [60,63,66], the extent of residual disease prior to HIPEC [55,60,63,[66][67][68], patient age [55,60], WHO performance status [67], and the presence of lymph node metastases [55].…”