Intraperitoneal chemotherapy hyperthermia (HIPEC) for peritoneal carcinomatosis of ovarian cancer origin by fluid and CO₂recirculation using the closed abdomen technique (PRS-1.0 Combat): A clinical pilot study

Abstract

Background This paper reports a study of 21 patients with peritoneal carcinomatosis from ovarian cancer who underwent cytoreductive surgery and HIPEC by means of PRS-1.0 Combat®, a new model for closed abdomen HIPEC aimed at improving fluid distribution with assistance from a CO2 recirculation system. This new technology has been previously shown to be successful in an experimental study (pig model) performed by our group, and has been approved for use in our hospital. Methods Twenty-one patients with peritoneal carcinomatosis of ovarian cancer origin were included in the study. Cytoreductive surgery and HIPEC were performed by a closed abdomen fluid and CO2 recirculation technique using the PRS-1.0 Combat(®) model. We analysed the intraoperative safety tolerance and post-operative morbidity and mortality during the first 30 days. Results Between November 2011 and March 2014 21 patients with epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stage II-IV, were included in the study. During the procedure there were no significant haemodynamic or analytical disturbances. Complication rates were 38.1% and 57.14% for grade III/IV and minor (grade I/II) complications, respectively. Post-operative mortality was 4.76% (one patient). Complete cytoreductive surgery and intraperitoneal chemotherapy improved overall survival and disease-free survival in women with advanced ovarian cancer. The association of intra-abdominal hyperthermia with chemotherapy (HIPEC) increased the therapeutic benefit. Conclusions This study has shown that closed abdomen intraperitoneal chemohyperthermia by a fluid and CO2 recirculation system (PRS-1.0 Combat(®)) can be a safe and feasible model for the treatment of peritoneal carcinomatosis of ovarian cancer origin.

Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer

“…Pilot studies using carbon dioxide for drug circulation, eliminating the need for manual agitation, are also safe and feasible [26]. Fagotti et al also demonstrated that a minimally invasive surgical (MIS) approach to HIPEC treatment in patients with recurrent disease is practical, with minimal complications [27].…”

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial and recurrent ovarian carcinoma: a single center experience

“…New investigative techniques such as fluid and CO 2 recirculation using the closed abdomen technique (PRS-1.0 Combat) show that closed abdomen intraperitoneal chemo-hyperthermia by a fluid and CO 2 recirculation system (PRS-1.0 Combat V R ) can be a safe and feasible model for the treatment of peritoneal carcinomatosis of ovarian cancer origin [24].…”

Usefulness of thermographic analysis to control temperature homogeneity in the development and implementation of a closed recirculating CO2 chemohyperthermia model

“…The application for monitoring the distribution of chemohyperthermia after cytoreductive surgery has only been done in a closed model by J€ ager et al [18], and our Group [19]. Our group incorporated the use of thermography in the closed HIPEC system development with the recirculation of CO 2 as a routine activity for the implementation of this technique [19].…”