Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer: Feasibility, Compliance, and Complications

Benedetti‐Panici, Pierluigi; Perniola, Giorgia; Marchetti, Cláudia; Pernice, Milena; Donfrancesco, Cristina; Donato, Violante Di; Tomao, Federica; Palaia, Innocenza; Graziano, Marialida; Basile, Stefano; Bellati, Filippo

doi:10.1097/igc.0b013e31825736b2

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…According to our results, IPC was well-tolerated. In particular, direct intraperitoneal puncture, avoiding permanent catheterization, was associated with minor toxicities when compared with historical series of IPC administrated by permanent catheter, confirming the reports of Lan et al (19) and Benedetti-Panici et al (20) in a first-line setting. In particular, we recorded one possible toxic death but the clinical impression was of multi-organ failure, in the context of heavily pretreated disease not responding to last-resort therapy.…”

Section: Discussionsupporting

confidence: 80%

“…Of note, there are no data for direct intraperitoneal puncture applied in a non-drug-naïve setting, in particular for heavily pre-treated patients. The aim of the present study was to assess both efficacy and tolerability of IPC performed with direct puncture (as an alternative approach to permanent catheter) (19)(20) for the treatment of previously treated patients with advanced ovarian cancer in a real-life setting.…”

mentioning

confidence: 99%

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Intraperitoneal Chemotherapy in Patients Pretreated for Ovarian Cancer Matched with Patients Treated with Parenteral Chemotherapy

Nicoletto

Casarin

Baldoni

et al. 2016

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Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Intraperitoneal Chemotherapy in Patients Pretreated for Ovarian Cancer Matched with Patients Treated with Parenteral Chemotherapy

Nicoletto

Casarin

Baldoni

et al. 2016

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“…Nonetheless, several issues have limited the integration of IP/IV chemotherapy into practice, the most important concerning the high rate of complications caused by the IP catheter, from which follows low feasibility and compliance of IP therapy. In fact, the incidence of IP access device-related complications ranges between 7% and 34% with a consequently high discontinuation rate [10].…”

Section: What Are the Critical Obstacles And The Next Challenges To Imentioning

confidence: 99%

“…In a prospective pilot study we investigated the feasibility, complication rate, and compliance of the administration of IP chemotherapy by direct puncture under ultrasonographic guidance [10]. Among the 38 patients enrolled, with 402 IP procedures performed we found the feasibility rate was 97.4%.…”

Section: What Are the Critical Obstacles And The Next Challenges To Imentioning

confidence: 99%

Intraperitoneal chemotherapy in ovarian cancer treatment: are we missing something?

Marchetti¹

2016

CBN

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“…Contrary to total hysterectomy with bilateral salpingo-oophorectomy, which is the recommended surgical treatment, the place of lymphadenectomy is currently under debate. Although recent randomized trials and a meta-analysis showed that pelvic lymphadenectomy had no affect on either overall or recurrence-free survival rates for patients with early-stage endometrial cancer [1][2][3], the positive affect of both pelvic and para-aortic lymphadenectomy in patients with high-risk endometrial cancer has been clearly demonstrated [4].…”

Section: Introductionmentioning

confidence: 99%

Lower-Limb Drainage Mapping for Lymphedema Risk Reduction After Pelvic Lymphadenectomy for Endometrial Cancer

et al. 2013

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Objectives. Pelvic lymphadenectomy is associated with a significant risk of lower-limb lymphedema. In this proof-of-concept study, we evaluated the feasibility of identifying the lower-limb drainage nodes (LLDNs) during pelvic lymphadenectomy for endometrial cancer. Secondary objectives were to map lower-limb drainage and to assess the diagnostic value of our mapping technique. Methods. This prospective study included patients with endometrial cancer requiring pelvic lymphadenectomy, without neoadjuvant radiotherapy or chemotherapy and without history of lower-limb surgery. A radiopharmaceutical was injected into both feet on the day before surgery. LLDNs were identified using preoperative lymphoscintigraphy and intraoperative isotopic probe detection, then removed before complete pelvic lymphadenectomy. LLDNs and pelvic lymphadenectomy specimens underwent separate histological analysis. Results.Of the 12 patients with early-stage endometrial cancer, 10 underwent preoperative lymphoscintigraphy, which consistently identified inguinal, femoral, and pelvic LLDNs (detection rate: 100%). The intraoperative detection rate was 83% (10/12). Median number of hot nodes per patient was 5 nodes (range: 3-7) on the right and 3 nodes (range: 2-6) on the left. Of 107 LLDNs, 106 were in the external iliac area, including 38 in the lateral group and 45 in the intermediate and medial groups. None of the patients had node metastases at any site. No early complications related to the technique occurred. Conclusion.Our mapping technique appears feasible, safe, and associated with a high LLDN identification rate. LLDN mapping may allow the preservation of LLDNs, thereby decreasing the risk of lower-limb lymphedema and improving quality of life. The Oncologist 2013;18:174 -179 Implications for Practice: Pelvic lymphadenectomy is associated with substantial postoperative morbidity related to the removal of pelvic lower-limb drainage nodes, which are not identified during the procedure. The sentinel node biopsy technique has been developed to decrease lymphadenectomy-related morbidity. In some gynecological cancers, however, routine pelvic lymphadenectomy remains required. Our proof-of-concept study was designed to evaluate the feasibility of identifying the lower-limb drainage nodes (LLDNs) during pelvic lymphadenectomy for endometrial cancer. Our results hold promise for preserving the lymphatic drainage pathways of the lower limbs. Sparing the LLDNs may decrease the risk of lower-limb lymphedema, which is associated with both a decrease in quality of life and additional healthcare costs.

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Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer: Feasibility, Compliance, and Complications

Abstract: The administration of IP chemotherapy with a direct puncture, under ultrasound guidance, for patients with ROC, is a safe and feasible method, with a high acceptance from patients.

Cited by 12 publications

References 15 publications

Intraperitoneal Chemotherapy in Patients Pretreated for Ovarian Cancer Matched with Patients Treated with Parenteral Chemotherapy

Intraperitoneal Chemotherapy in Patients Pretreated for Ovarian Cancer Matched with Patients Treated with Parenteral Chemotherapy

Intraperitoneal chemotherapy in ovarian cancer treatment: are we missing something?

Lower-Limb Drainage Mapping for Lymphedema Risk Reduction After Pelvic Lymphadenectomy for Endometrial Cancer

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