Update on Intraperitoneal Chemotherapy for the Treatment of Epithelial Ovarian Cancer

Gourley, Charlie; Walker, Joan L.; Mackay, Helen

doi:10.14694/edbk_158927

Cited by 10 publications

(7 citation statements)

References 48 publications

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“…Recent evidence, including a randomized controlled trial and a meta-analysis, demonstrated similar results for PM of colorectal origin with a significant survival benefit in HIPEC patients [15-17]. However, despite a proven survival benefit, intraperitoneal chemotherapy delivery was not universally adopted, mainly due to criticism regarding study design or limited resources and fear of side effects [8], similar as in the present study. Likewise, progress was achieved in systemic therapy during recent years, with survival rates of up to 24 months for PM-specific colorectal metastasis, 33–34 months for stage IV ovarian cancer with PM, and up to 14 months for first-line therapy in gastric cancer, which were, however, not PM specific [3, 17, 18].…”

Section: Discussionsupporting

confidence: 74%

“…Treatment options are limited, either due to pharmacokinetic limitations of systemic chemotherapy [3, 4] or restricted patient eligibility for cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) due to considerable perioperative morbidity and mortality [5, 6]. Furthermore, specific guidelines for PM are scarce and not uniform, and treatment approaches vary widely [7, 8]. …”

Section: Introductionmentioning

confidence: 99%

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Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Grass¹,

Martin²,

Montemurro³

et al. 2018

Chemotherapy

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Aims of the Study: The present survey aimed to evaluate current opinion and practice regarding peritoneal metastasis (PM), satisfaction with available treatment options, and need for new therapeutic approaches. Methods: This was a qualitative study conducted between October 2016 and October 2017 in the Réseau Suisse Romand d’Oncologie including 101 members of various oncological specialties. Participants’ demographics, current practice, knowledge, and satisfaction regarding available treatment options and need for new treatment options were assessed by semantic differential scales through 33 closed questions with automatic reminders at 4-, 8-, 12-, and 16-week intervals. Results: Twenty-seven participants (27%) completed the survey. Participants were gastrointestinal or gynecologic oncologists and surgeons. Most participants (67%) evaluated their knowledge on PM as moderate, while 22% considered themselves as experts. Clinical usefulness of systemic chemotherapy and hyperthermic intraperitoneal chemotherapy was judged to be moderate to high for PM of ovarian and colorectal origin and moderate to poor for gastric origin. Satisfaction with available treatment options was 6/10 (interquartile range [IQR] 4–7) for ovarian, 5/10 (IQR 3–7) for colorectal, and 3/10 (IQR 1–3) for gastric PM. Treatment strategies varied widely for typical case vignettes. The need for new treatment modalities was rated as 8/10 (IQR 6–10). Conclusion: Usefulness of and satisfaction with available treatment options for PM were rated as moderate at best by oncological experts, and treatment strategies differed importantly among participants. There appears to be a clear need for standardization and new treatment modalities.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Grass¹,

Martin²,

Montemurro³

et al. 2018

Chemotherapy

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“…9 Disparities in its use may also stem from issues associated with increased resources and catheter-related complications, and that to overcome these would require time and specialist training. 30 The benefits of bevacizumab are debated since it is yet to demonstrate improvements in overall survival. 31 Given international differences in national health services spending, 32 inequalities in access to high-cost drugs like bevacizumab may reflect different levels of available investment.…”

Section: Surgerymentioning

confidence: 99%

Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

Norell

Butler

Farrell

et al. 2020

Int J Gynecol Cancer

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IntroductionThe International Cancer Benchmarking Partnership demonstrated international differences in ovarian cancer survival, particularly for women aged 65–74 with advanced disease. These findings suggest differences in treatment could be contributing to survival disparities.ObjectiveTo compare clinical practice guidelines and patterns of care across seven high-income countries.MethodsA comparison of guidelines was performed and validated by a clinical working group. To explore clinical practice, a patterns of care survey was developed. A questionnaire regarding management and potential health system-related barriers to providing treatment was emailed to gynecological specialists. Guideline and survey results were crudely compared with 3-year survival by ‘distant’ stage using Spearman’s rho.ResultsTwenty-seven guidelines were compared, and 119 clinicians completed the survey. Guideline-related measures varied between countries but did not correlate with survival internationally. Guidelines were consistent for surgical recommendations of either primary debulking surgery or neoadjuvant chemotherapy followed by interval debulking surgery with the aim of complete cytoreduction. Reported patterns of surgical care varied internationally, including for rates of primary versus interval debulking, extensive/‘ultra-radical’ surgery, and perceived barriers to optimal cytoreduction. Comparison showed that willingness to undertake extensive surgery correlated with survival across countries (rs=0.94, p=0.017). For systemic/radiation therapies, guideline differences were more pronounced, particularly for bevacizumab and PARP (poly (ADP-ribose) polymerase) inhibitors. Reported health system-related barriers also varied internationally and included a lack of adequate hospital staffing and treatment monitoring via local and national audits.DiscussionFindings suggest international variations in ovarian cancer treatment. Characteristics relating to countries with higher stage-specific survival included higher reported rates of primary surgery; willingness to undertake extensive/ultra-radical procedures; greater access to high-cost drugs; and auditing.

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“…Studies have shown an outcome benefit, but barriers to widespread uptake include increased toxicity, inconvenience and extra cost. 27 Intraperitoneal chemotherapy can also be administered as part of maximal cytoreductive surgery at the time of peritonectomy using heated intraperitoneal chemotherapy (HIPEC). This requires significant resources including access to an intensive care unit.…”

Section: Intraperitoneal Chemotherapy and Hipecmentioning

confidence: 99%

Advances in epithelial ovarian cancer

Neesham¹,

Richards²,

McGauran³

2020

Aust J Gen Pract

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Update on Intraperitoneal Chemotherapy for the Treatment of Epithelial Ovarian Cancer

Cited by 10 publications

References 48 publications

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Current Opinion and Knowledge on Peritoneal Carcinomatosis: A Survey among a Swiss Oncology Network

Exploring international differences in ovarian cancer treatment: a comparison of clinical practice guidelines and patterns of care

Advances in epithelial ovarian cancer

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