Hyperthermic Intraperitoneal Perfusion Chemotherapy and Cytoreductive Surgery for Controlling Malignant Ascites From Ovarian Cancer

Ba, Mingchen; Long, Hui; Zhang, Xiangliang; Tang, Yunqiang; Wu, Yinbing; Wang, Shuai; Zhang, Yan; Zhang, Bohuo; Cui, Shuzhong

doi:10.1097/igc.0000000000000809

Cited by 14 publications

(10 citation statements)

References 42 publications

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“…Rates of complete cytoreduction (R0 resection) varied from 50% to 100% in these trials, [38][39][40][42][43][44][45][46][47][48]50,51 and univariable and multivariable analyses showed that residual disease after debulking was the strongest predictor of OS. 38,39,[43][44][45]53,55 Therefore, NCCN recommends maximum effort to achieve complete cytoreduction during IDS, regardless of whether HIPEC is planned.…”

Section: Hyperthermic Intraperitoneal Chemotherapy At the Time Of Idsmentioning

confidence: 99%

NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

Armstrong

Alvarez

Bakkum-Gamez³

et al. 2019

Journal of the National Comprehensive Cancer Network

231

212

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Epithelial ovarian cancer is the leading cause of death from gynecologic cancer in the United States, with less than half of patients living >5 years from diagnosis. A major challenge in treating ovarian cancer is that most patients have advanced disease at initial diagnosis. The best outcomes are observed in patients whose primary treatment includes complete resection of all visible disease plus combination platinum-based chemotherapy. Research efforts are focused on primary neoadjuvant treatments that may improve resectability, as well as systemic therapies providing improved long-term survival. These NCCN Guidelines Insights focus on recent updates to neoadjuvant chemotherapy recommendations, including the addition of hyperthermic intraperitoneal chemotherapy, and the role of PARP inhibitors and bevacizumab as maintenance therapy options in select patients who have completed primary chemotherapy.

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Section: Hyperthermic Intraperitoneal Chemotherapy At the Time Of Idsmentioning

confidence: 99%

NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

Armstrong

Alvarez

Bakkum-Gamez³

et al. 2019

Journal of the National Comprehensive Cancer Network

231

212

View full text Add to dashboard Cite

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“…This recommendation is based on the evidence that the synergistic effect of hyperthermia and cisplatin can be dramatically increased at 42°C [10]. Data from clinical research also confirmed the safety and effectiveness of HIPEC at 43°C [31][32][33][34]. In general, the properties of biological tissues, the toxicity of drugs and their mutual influences change under hyperthermic conditions; some of the changes are temperature dependent [35].…”

Section: Hipec-related Aes Are Summarized In Supplementarymentioning

confidence: 99%

Calculating the dose of cisplatin that is actually utilized in hyperthermic intraperitoneal chemotherapy among ovarian cancer patients

Wang

et al. 2021

J Ovarian Res

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Background Hyperthermic intraperitoneal chemotherapy (HIPEC) is an important treatment for ovarian cancer. A certain portion of cisplatin exits the body via the perfusate at the end of HIPEC, so full-dose utilization cannot be achieved. Herein, we sought to explore how much cisplatin is actually utilized and its prognostic influence. Methods Cisplatin (70 mg/m2) was given at 43 °C for 90 min. The actually utilized dose (AD) of cisplatin was calculated using the following formula: AD (mg) = total dose (TD) (mg)-losing dose (LD) (mg); LD = volume (ml) of the perfusate (VPretained) that was retained in the HIPEC treatment system at the end of HIPEC * concentration of cisplatin in the perfusate (mg/ml). Result Sixty-two ovarian cancer patients were included. The median TD, median LD and median AD were 95 mg, 20.7 mg and 75.8 mg, respectively. The utility rate of cisplatin (AD/TD ratio) was 79.2%. On simple linear regression analysis, the TD and VPretained were found to significantly predict the AD. Based on these two factors, multiple linear regression analysis was conducted, and a significant regression equation was formulated [F (2, 59) = 71.419, P < 0.0001]: predicted AD (mg) = 30.079 + 0.667 TD (mg) – 0.010 VPretained (ml) (adjusted R2 = 0.698). In Cox regression analysis, AD was not noted to be associated with progression free survival or overall survival. Conclusion For ovarian cancer patients who receive cisplatin for HIPEC at 43 °C, the AD of cisplatin can be predicted using a regression equation and it has no prognostic impact.

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“…Alternatively, Ba et al placed catheters laparoscopically and then performed the first session of HIPEC in the operating room followed by two more sessions in the ICU on postoperative days 1 and 2. Both Ba and Valle found an average increase in Karnofsky performance scores (KPS) of 20 points after treatment. Orgiano et al found an increase in median PuFS from 11.2 to 39.5 days .…”

Section: Treatmentmentioning

confidence: 99%

“…Orgiano et al found an increase in median PuFS from 11.2 to 39.5 days . Adverse effects associated with HIPEC include nausea, vomiting, abdominal pain, abdominal wall metastases, peritoneal inflammation, neutropenia, and bone marrow suppression …”

Section: Treatmentmentioning

confidence: 99%

Palliation of malignant ascites

Hodge

Badgwell

2019

Journal of Surgical Oncology

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Malignant ascites (MA) carries a poor prognosis. It can have a significant impact on quality of life (QOL), with increasing abdominal distention, pain, and dyspnea. Diuretics typically do not work well for MA. Paracentesis is effective in providing temporary symptom relief but requires frequent repeat procedures. Options for durable symptom management include indwelling catheters, peritoneal ports, peritoneovenous shunts, intraperitoneal (i.p.) catumaxomab, and hyperthermic i.p. chemotherapy. These interventions do not necessarily improve overall survival but may improve QOL. K E Y W O R D S catumaxomab, hyperthermic intraperitoneal chemotherapy, paracentesis, peritoneal carcinomatosis 1 | INTRODUCTION Malignant ascites (MA) is not among the more common indications for palliative surgical consultation, such as bowel obstruction,gastrointestinal bleeding, and wound problems. However, MA, when refractory to medical management or paracentesis, can represent a challenging palliative clinical scenario. There is a paucity of clinical trials or even prospective studies to guide treatment. As with other indications for palliative surgical consultation, the optimal treatment is often a balance between the known risks of a given procedure and the potential for symptom improvement. Of course, the goals of the patient, in the background of their prognosis and treatment options for their malignancy, ultimately guide decision making. In this review article, we will cover the signs and symptoms, etiology, diagnosis, treatment options, and associated outcomes for patients with MA.MA is a poor prognostic indicator and has a detrimental effect on quality of life (QOL). Reported prognosis for survival at the time of diagnosis of MA varies from 1 to 6 months. 1-5 Although there have been advances in chemotherapy, newer studies still have found a median survival of 5.6 months. 6 Approximately 11% of patients survive greater than 6 months once MA develops. 7 However, MA secondary to ovarian cancer is associated with a longer life expectancy than MA from other types of cancer and has been reported up to 10 to 24 months. 7 The end-stage nature of this presentation requires careful evaluation and deliberation regarding options for management. | ETIOLOGYAlthough MA is most commonly associated with ovarian cancer (25%-28% of all cases of MA), 6,8 it is also associated with colorectal, pancreatic, uterine, gastric, and primary peritoneal cancers, as well as extra-abdominal tumors such as lymphoma, lung, and breast cancer. 1,3,6,8,9 Given the predominance of ovarian cancer as well as the association with breast cancer, MA occurs more commonly in women than men. 5,6 Up to 20% of cases of MA have an unknown primary tumor. 3,6 MA is the presenting sign or symptom of malignancy in about 50% of cases. 3,10 Patients with gastric and ovarian cancer are more likely to have an MA at the time of the first diagnosis, whereas patients with breast cancer tend to develop MA months or even years after initial diagnosis and treatment. 6 MA occurs via a diff...

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Hyperthermic Intraperitoneal Perfusion Chemotherapy and Cytoreductive Surgery for Controlling Malignant Ascites From Ovarian Cancer

Abstract: Hyperthermic intraperitoneal chemotherapy is effective at controlling ascites in patients with OC, even for patients in poor condition before CRS, or when complete CRS is not feasible. Furthermore, the regression of ascites appears not to be dependent on complete resection.

Cited by 14 publications

References 42 publications

NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

NCCN Guidelines Insights: Ovarian Cancer, Version 1.2019

Calculating the dose of cisplatin that is actually utilized in hyperthermic intraperitoneal chemotherapy among ovarian cancer patients

Palliation of malignant ascites

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