Cytoreductive Surgery With or Without HIPEC in the Management of Peritoneal Dissemination from Rare Histological Subtypes of Ovarian Cancer — a Retrospective Study by INDEPSO

Sinukumar, Snita; Damodaran, Dileep; Ray, M. D.; Prabhu, Aruna; Katdare, Ninad; Vikram, Syam; Shaikh, Sakina; Patel, Ankita; Bhatt, Aditi

doi:10.1007/s13193-022-01640-5

Cited by 2 publications

(2 citation statements)

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“…These studies mainly consisted of heterogeneous cohorts including non-gynecologic tumors, analyzed all together and with limited information by tumor type [ 10 , 37 ]. The PSOGI Working Group (2018) and INDEPSO (2022) have reported two cohorts of patients with rare ovarian cancer treated with CRS/HIPEC [ 2 , 9 ]. Both demonstrated an acceptable morbidity (major complication rate: 42.2 and 15.8 %, respectively) and feasibility for achieving complete CRS (CC-0/1: 92.5 and 81.2 %, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…Peritoneal spread of ovarian cancer can display a similar clinical presentation to these peritoneal surface malignancies. This is especially true in some rare ovarian tumors (mucinous ovarian cancer), where voluminous, mucinous ascites, and poor chemotherapy response is observed [ 8 ], [ 9 ], [ 10 ]. In line with this, evidence shows that epithelial ovarian cancer can also benefit from CRS/HIPEC by prolonging time to recurrence [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Peritoneal metastases from rare ovarian cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC)

Falla-Zuniga,

Sardi,

King

et al. 2023

Pleura and Peritoneum

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Objective There are limited treatment options and no consensus on the management of advanced rare ovarian malignancies. Rare ovarian malignancies can present with peritoneal metastases (PM), featuring a similar presentation to more common ovarian subtypes. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is an effective treatment for PM of non-gynecologic origin and, recently, epithelial ovarian cancer. We evaluated the feasibility of CRS/HIPEC in the management of PM from rare ovarian malignancies and report postoperative outcomes on these patients. Methods A retrospective review of a single center, prospective database (1994–2021) was performed to identify patients with rare ovarian malignancies treated with CRS/HIPEC. Clavien-Dindo 90-day morbidity/mortality and Kaplan–Meier overall (OS) and progression-free survival (PFS) were analyzed. Results Of 44 patients identified, 28 underwent CRS/HIPEC. Six were aborted due to extensive disease. Histologic subtypes included: clear cell (5/28, 17.9 %), endometrioid (5/28, 17.9 %), granulosa cell (3/28, 10.7 %), low-grade serous (6/28, 21.4 %), mesonephric (1/28, 3.6 %), mucinous (6/28, 21.4 %), and small cell (2/28, 7.1 %) carcinomas. Eight (28.6 %) patients had primary and 20 (71.4 %) had recurrent disease. Median peritoneal cancer index (PCI) was 21 (IQR: 6–29). Complete cytoreduction (<2.5 mm residual disease) was achieved in 27/28 (96.4 %). Grade III/IV complications occurred in 9/28 (32.1 %) with one (3.6 %) mortality. After a median follow-up of 65.8 months, 20 patients were alive. Five-year OS and PFS were 68.5 and 52.6 %, respectively. Conclusions In patients with PM from rare ovarian malignancies, CRS/HIPEC is feasible and has an acceptable safety profile. Longer follow-up and multicenter trials are needed.

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