A phase 3 trial of hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer.

Driel, Willemien J. van; Sikorska, Karolina; Leeuwen, Jules Schagen van; Schreuder, Henk W.R.; Hermans, R; Hingh, Ignace de; Velden, J. van der; Arts, Henriëtte J.G.; Massuger, Leon; Aalbers, Arend G. J.; Victor, Joel; Vijver, Koen van der; Aaronson, Neil K.; Sonke, Gabe S.

doi:10.1200/jco.2017.35.15_suppl.5519

Cited by 16 publications

(5 citation statements)

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“…Several studies show the beneficial effect of IP chemotherapy after cytoreductive surgery for ovarian cancer patients, resulting in an increase of median survival [ 31 32 33 34 ]. Other studies, including a recent Dutch study, demonstrated the beneficial effect of HIPEC on recurrence free and overall survival in ovarian cancer patients [ 35 36 37 38 39 ]. In our study, we have shown that serous and clear cell histology in endometrial cancer is an independent predictor for the occurrence of PM.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Burg

Timmermans

et al. 2020

J Gynecol Oncol

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Objective: Peritoneal metastases (PM) are a challenge in gynecological cancers, but its appearance has never been described in a population-based study. Therefore, we describe the incidence of PM and identify predictors that increase the probability of peritoneal spread. Methods: All ovarian, endometrial and cervical cancer patients diagnosed in the Netherlands between 1989 and 2015 were identified from the Netherlands Cancer Registry and stratified for PM. Crude and age-adjusted incidence over time was calculated. Independent predictors for PM were identified using uni-and multivariable analyses. Results: The 94,981 patients were diagnosed with ovarian, endometrial or cervical cancer and respectively 61%, 2% and 1% presented with PM. Predictors for PM in ovarian cancer were: age between 50 and 74 years (odds ratio [OR]=1.19; 95% confidence interval [CI]=1.08-1.32), other distant metastases (OR=1.25; 95% CI=1.10-1.41), poor differentiation grade (OR=2.00; 95% CI=1.73-2.32) and serous histology. Predictors in endometrial cancer were lymph node metastases (OR=2.32; 95% CI=1.65-3.26), other distant metastases (OR=1.38; 95% CI=1.08-1.77), high-grade tumors (OR=1.95; 95% CI=1.38-2.76) and clear cell (OR=1.49; 95% CI=1.04-2.13) or serous histology (OR=2.71; 95% CI=2.15-3.42). In cervical cancer, the risk is higher in adenocarcinoma than in squamous cell carcinoma (OR=4.92; 95% CI=3.11-7.79). Conclusion: PM are frequently seen in patients with ovarian cancer. In endometrial and cervical cancer PM are rare. Histological subtype was the strongest predictive factor for PM in all 3 cancers. Better understanding of predictive factors for PM and thus the biological behavior is of paramount importance.

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Section: Discussionmentioning

confidence: 99%

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Burg

Timmermans

et al. 2020

J Gynecol Oncol

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“…Because maintenance of a leak-free pneumoperitoneum of 12 mm Hg is essential, every potential cause of spread of aerosol from the pneumoperitoneum through the trocars must be evaluated. Therefore, airtight balloon trocars are used; the port of the balloons is closed with a cap; the luer lock of the 5 mm trocar is closed; and the CO 2 inflator tube, which is connected with the 12 mm balloon trocar, has a KV-5 filter (Olympus, Hamburg, Germany) at its Figure 1: Schematic overview of the ePIPAC setup used at Ghent University Hospital, and of the different samples that were obtained for analysis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). CAWS, closed aerosol waste system.…”

Section: Methodsmentioning

confidence: 99%

“…Peritoneal metastasis is a defining feature of stage III ovarian cancer and occurs in approximately 13 % of gastric cancers, 9 % of pancreas cancers, and 8 % of colorectal cancers [1][2][3][4]. In selected patients, cytoreductive surgery combined with hyperthermic intraperitoneal chemoperfusion (HIPEC) results in a significant survival advantage compared to palliative treatment alone [5,6].…”

Section: Introductionmentioning

confidence: 99%

Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

Willaert

Paul

Ceelen

2017

Pleura and Peritoneum

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Background: Pressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel method to treat extensive, small volume peritoneal metastases. The clinical use of chemotherapy containing aerosols represents a potential occupational health hazard. We report the results of toxicological analysis during the first two clinical PIPAC procedures performed at Ghent University Hospital. Methods: After extensive preparation and in vitro testing, two patients were treated with PIPAC: the first using doxorubicin (2.86 mg in 51.43 mL) and cisplatin (14.28 mg in 164.3 mL), the second using oxaliplatin (182.10 mg in 186.42 mL). A standardized safety checklist was developed and used. Aerosol delivery was combined with electrostatic precipitation (ePIPAC). The following samples were obtained at several time points and locations: environmental air, floor surface wipes, surgeon's gloves, surgeon's hand wipes, circuit filters, and fluid from the water seal collection chamber container placed along the closed aerosol waste evacuating line. Platinum concentration was measured in these samples using voltammetry. Sample collection and analysis were performed by an independent external laboratory. Results: Platinum was not detected on the four floor locations after both procedures (detection limit 0.02 ng/ cm 2 ). Similarly, no platinum was detected in environmen-

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“…CRS and HIPEC represent the only curative option in patients with peritoneal carcinomatosis of colorectal and gastric cancer [13][14][15]. It also represent the gold standard therapy for peritoneal mesothelioma, pseudomyxoma peritonei and advanced high grade serous ovarian cancer [16][17][18]. This therapeutic approach is not always possible and still reserved to carefully selected patients.…”

Section: Introductionmentioning

confidence: 99%

An International Registry of Peritoneal Carcinomatosis from Appendiceal Goblet Cell Carcinoma Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

et al. 2022

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Purpose Peritoneal carcinomatosis from appendiceal goblet cell carcinoma (A-GCC) is a rare and aggressive form of appendiceal tumor. Cytoreductive surgery (CRS) and hyperthermic intra peritoneal chemotherapy (HIPEC) was reported as an interesting alternative regarding survival compared to surgery without HIPEC and/or systemic chemotherapy. Our aim was to evaluate the impact of CRS and HIPEC for patients presenting A-GCC through an international registry. Methods A prospective multicenter international database was retrospectively searched to identify all patients with A-GCC tumor and peritoneal metastases who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI). The post-operative complications, long-term results, and principal prognostic factors were analyzed. Results The analysis included 83 patients. After a median follow-up of 47 months, the median overall survival (OS) was 34.6 months. The 3-and 5-year OS was 48.5% and 35.7%, respectively. Patients who underwent complete macroscopic CRS had a significantly better survival than those treated with incomplete CRS. The 5-year OS was 44% and 0% for patients who underwent complete, and incomplete CRS, respectively (HR 9.65, p \ 0.001). Lymph node involvement and preoperative chemotherapy were also predictive of a worse prognosis. There were 3 postoperative deaths, and 30% of the patients had major complications. Conclusion CRS and HIPEC may increase long-term survival in selected patients with peritoneal metastases of A-GCC origin, especially when complete CRS is achieved. Ideally, randomized control trials or more retrospective data are needed to confirm CRS and HIPEC as the gold standard in this pathology.The members of the PSOGI and BIG-RENAPE Working Group are listed in the Acknowledgements section.

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A phase 3 trial of hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer.

Cited by 16 publications

References 0 publications

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Incidence and predictors of peritoneal metastases of gynecological origin: a population-based study in the Netherlands

Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

An International Registry of Peritoneal Carcinomatosis from Appendiceal Goblet Cell Carcinoma Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

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