Cytoreductive surgery plus HIPEC in platinum-sensitive recurrent ovarian cancer patients: A case–control study on survival in patients with two year follow-up

Fagotti, Anna; Costantini, Barbara; Petrillo, Marco; Vizzielli, Giuseppe; Fanfani, Francesco; Margariti, Pasquale Alessandro; Turco, Luigi Carlo; Piovano, Elisa; Scambia, Giovanni

doi:10.1016/j.ygyno.2012.09.020

Cited by 96 publications

(73 citation statements)

References 19 publications

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“…There are 5 case control studies that have compared CRS and HIPEC with CRS alone [67][68][69][70][71] and all but one have shown a statistically significant benefit of CRS and HIPEC over CRS alone. These studies are listed in Table 3.…”

Section: Hipec As Second Line Therapymentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

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Ovarian cancer is one of the leading causes of cancer related deaths in women worldwide. It is usually diagnosed in an advanced stage (Stages III and IV) when peritoneal cancer spread has already occurred. The standard treatment comprises of surgery to remove all macroscopic disease followed by systemic chemotherapy. Despite all efforts, it recurs in over 75 % of the cases, most of these recurrences being confined to the peritoneal cavity. Recurrent ovarian cancer has a poor long term outcome and is generally treated with multiple lines of systemic chemotherapy and targeted therapy. The propensity of ovarian cancer to remain confined to the peritoneal cavity warrants an aggressive locoregional approach. The combined treatment comprising of cytoreductive surgery (CRS) that removes all macroscopic disease and HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been effective in providing long term survival in selected patients with peritoneal metastases of gastrointestinal origin. Intraperitoneal chemotherapy used as adjuvant therapy has shown a survival benefit in ovarian cancer. This has prompted the use of CRS and HIPEC in the management of ovarian cancer as a part of first line therapy and second line therapy for recurrent disease. This article reviews the current literature and evidence for the use of HIPEC in ovarian cancer.

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Section: Hipec As Second Line Therapymentioning

confidence: 99%

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Bhatt

Gléhen

2016

Indian J Surg Oncol

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“…Average surgery duration was 9 ± 2.7 h (range 5. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Mean perfusion temperature used was (42 ± 0.49°C).…”

Section: Resultsmentioning

confidence: 99%

Complications of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Advanced Ovarian Malignancies: First Indian Study

Prasanna

Jaka

et al. 2015

Indian J Gynecol Oncolog

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Background Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS ? HIPEC) has been proposed as a treatment for advanced ovarian carcinoma and pseudomyxoma peritonii. We analyzed the perioperative complications of extensive CRS ? HIPEC in Indian patients with advanced ovarian malignancies and pseudomyxoma peritonii. Methods In this prospective observational study, we included 38 patients from February 2013 to June 2015 with advanced EOC and pseudomyxoma peritonii treated by a dedicated peritoneal malignant disease treatment team in a tertiary care hospital. All patients underwent extensive CRS ? HIPEC. The post-operative morbidity and mortality were analyzed. Results Our patients were grouped into frontline 21.1 % (n = 8), interval cytoreduction 50 % (n = 19), and secondary cytoreduction 28.9 % (n = 11) based on the timeline at presentation. Mean peritoneal carcinomatosis index (PCI) was 8.5 ± 7.45 (range 3-36). Average surgery duration was 9 ± 2.7 h (range 5.5-19). Mean perfusion temperature used was (42 ± 0.49°C). Patients with PCI score C15 had prolonged gastrointestinal recovery (p = 0.043), post-operative ventilator need (p = 0.011), acute respiratory distress syndrome (ARDS) (p = 0.014), and dyspnea (p = 0.002) with trend towards adverse events. Closed method HIPEC was associated with prolonged hospital stay (p = 0.011), woundrelated complications (p = 0.006), and ARDS (p \ 0.001). Multivisceral resections were associated with increased ventilator need (p \ 0.001), ARDS (p = 0.010), and adverse events (p = 0.044). The recurrent ovarian carcinomas were associated with more wound-related complications (p = 0.016). More adverse events with cisplatin 100 mg/m 2 (p = 0.03) were dyselectrolytemia, acute renal failure, and fall in hemoglobin. No 30-day mortality was present. After a median follow-up of 17 (3-28) months, 15.8 % patients (n = 6) had recurrences and 5.3 % (n = 2) succumbed to disease. Conclusion Ovarian peritoneal malignancies known for peritoneal recurrences are amenable for extensive cytoreduction and HIPEC with acceptable morbidity in Indian patients. A dedicated team of surgeon, anesthetist, medical oncologist, and intensivist is mandatory for better outcome.

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“…Data from published trials [36,38] regarding the use of HIPEC in platinum-sensitive recurrent EOC patients showed a median DFS and OS of 24 and 38 months, respectively, with an estimated PFS and OS at 3 years of 44 % and 92 %, respectively. These data not only confirmed previously reported data but are more significant, probably because of the highly selected population-a characteristic that contrasts with the wide heterogeneity of patients enrolled in most other trials until now.…”

Section: New Trials In Primary and Recurrent Ovarian Cancermentioning

confidence: 99%

“…These data not only confirmed previously reported data but are more significant, probably because of the highly selected population-a characteristic that contrasts with the wide heterogeneity of patients enrolled in most other trials until now. Therefore, treatment with CRS plus HIPEC in platinum-sensitive recurrent EOC patients would seem to offer similar opportunities in terms of prognosis as those attained by primary treatment, with acceptable complication rates (morbidity and mortality ~ 35 % and 0 %, respectively) if complete tumor resection is obtained [36,38].…”

Section: New Trials In Primary and Recurrent Ovarian Cancermentioning

confidence: 99%

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Costantini¹,

Fagotti²,

Montori³

et al. 2015

Treatment of Peritoneal Surface Malignancies

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Cytoreductive surgery plus HIPEC in platinum-sensitive recurrent ovarian cancer patients: A case–control study on survival in patients with two year follow-up

Cited by 96 publications

References 19 publications

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

The role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer: A Review

Complications of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Advanced Ovarian Malignancies: First Indian Study

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