Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer with peritoneal metastasis: a prospective registry study on 41 patients

Abstract

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer with peritoneal metastasis: a prospective registry study on 41 patients https://doi.org/10. 1515/pap-2017-0021 Received August 7, 2017 accepted October 24, 2017; previously published online November 8, 2017 Abstract Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases from ovarian cancer have been shown to have a role in recurrent ovarian cancer, but are still not considered standard therapy. Methods: From March 2005 to July 2013, 41 patients who underwent 44 CRS and HIPEC for peritoneal metastases in recurrent ovarian cancer were included in this study. Details were obtained from a prospectively maintained database. Our aim was to report our 5-year overall and disease-free survivals, as well as prognostic factors for survival. Results: The median age was 50 years (range 23-73). Median duration of surgery was 510 min (range 230-840) and median peritoneal carcinomatosis index (PCI) score was 9.5 (range 0-31). About 92.7% of the patients had completeness of cytoreduction (CC) scores of 0 or 1. Median follow-up was 43.9 months (range 0.7-108.9). There were no mortalities and the high-grade morbidity rate was 31.8%. Median overall survival was 42.8 months (range 28.6-99.9) 5-year overall and disease-free survivals were 49.3% and 7.5% respectively. On multivariate analysis, histology and CC score were significantly associated with overall survival while histology and disease-free interval were associated with disease-free survival. The odds of developing a high-grade complication more than doubled for each additional surgical procedure performed (p = 0.01). Conclusions: CRS and HIPEC can attain prolonged survival in selected patients with peritoneal metastasis in recurrent ovarian cancer.

The addition of sodium thiosulphate to hyperthermic intraperitoneal chemotherapy with cisplatin in ovarian cancer

“…This is substantially lower than previous reports suggesting significantly higher rates of renal injury following cisplatin-based HIPEC in the absence of sodium thiosulphate nephroprotection ( Gonzalez Bayon et al, 2013 , Sin et al, 2017 , Sun et al, 2016 ). The reported incidence of renal injury after HIPEC using cisplatin at 100 mg m 2 without ST ranges from 0 to 8% ( Vaira et al, 2014 , Roviello et al, 2006 , Gori et al, 2005 , Teo et al, 2013 , Teo et al, 2017 Dec 1 , Tan et al, 2017 May , Cascales-Campos et al, 2014 Aug , Gouy et al, 2016 , Perazella, 2012 , Sun et al, 2016 ). Lower doses of cisplatin between 50 and 80 mg/m 2 , without the addition of ST, have also resulted in reports of severe kidney injury in patients who subsequently required dialysis following severe renal injury ( Zivanovic et al, 2015 , Eckardt and Kasiske, 2009 , Kellum and Lameire, 2013 , Elferink et al, 1986 , Nagai et al, 1995 ).…”