Morbidity and mortality outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with primary and recurrent advanced ovarian cancer

Campos, P. Cascales; Gil, José; Parrilla, Pascual

doi:10.1016/j.ejso.2013.08.013

Cited by 50 publications

(24 citation statements)

References 48 publications

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“…At the same time, univariate analysis identified PCI ≤ 20 as an independent factor for better survival. So far, there has been no clear dividing line to determine the degree of PCI, although most reports used PCI 10 [23] , 12 [31] , and 15 [32] , [33] , [34] as the dividing line. All these studies indicated that patients with limited peritoneal cancer (relatively LPCI) could benefit more from this comprehensive treatment, emphasizing the importance of patient selection.…”

Section: Discussionmentioning

confidence: 99%

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy to Treat Advanced/Recurrent Epithelial Ovarian Cancer: Results from a Retrospective Study on Prospectively Established Database

Sun

et al. 2016

Translational Oncology

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BACKGROUND: Despite the best standard treatment, optimal cytoreductive surgery (CRS) and platinum/taxane-based chemotherapy, prognosis of advanced epithelial ovarian carcinoma (EOC) remains poor. Recently, CRS plus hyperthermic intraperitoneal chemotherapy (HIPEC) has been developed to treat peritoneal carcinomatosis (PC). This study was to evaluate the efficacy and safety of CRS+HIPEC to treat PC from advanced/recurrent EOC. METHODS: Forty-six PC patients from advanced EOC (group A) or recurrent EOC (group B) were treated by 50 CRS+HIPEC procedures. The primary endpoints were progression-free survival (PFS) and overall survival (OS); the secondary endpoints were safety profiles. RESULTS: The median OS was 74.0 months [95% confidence interval (CI) 8.5-139.5] for group A versus 57.5 months (95% CI 29.8-85.2) for group B (P = .68). The median PFS was not reached for group A versus 8.5 months (95% CI 0-17.5) for group B (P = .034). Better median OS correlated with peritoneal cancer index (PCI) < 20 (76.6 months for PCI ≤ 20 group vs 38.5 months for PCI > 20 group, P = .01), complete cyroreduction (residual disease ≤ 2.5 mm) [79.5 months for completeness of cytoreduction (CC) score 0-1 vs 24.3 months for CC 2-3, P = .00], and sensitivity to platinum (65.3 months for platinum-sensitive group vs 20.0 for platinum-resistant group, P = .05). Serious adverse events occurred in five patients (10.0%). Multivariate analysis identified CC score as the only independent factor for better survival. CONCLUSION: For advanced/recurrent EOC, CRS+HIPEC could improve OS with acceptable safety.

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Section: Discussionmentioning

confidence: 99%

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy to Treat Advanced/Recurrent Epithelial Ovarian Cancer: Results from a Retrospective Study on Prospectively Established Database

Sun

et al. 2016

Translational Oncology

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“…Intestinal resection as part of CRS with HIPEC is associated with a higher rate of major morbidity, and not surprisingly a correlation between the number of bowel anastomoses and major morbidity/anastomotic leakage has been described . The effect of HIPEC on the anastomotic leak rate is still debated.…”

Section: Discussionmentioning

confidence: 99%

Morbidity after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with carboplatin used for ovarian, tubal, and primary peritoneal cancer

Mikkelsen

Christiansen

Petersen

et al. 2019

Journal of Surgical Oncology

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Background and objectives: Hypertherm intraperitoneal chemotherapy (HIPEC) is increasingly used in the treatment of ovarian, tubal, and primary peritoneal cancer (OC). The aim was to evaluate short‐term morbidity of cytoreductive surgery (CRS) and carboplatin HIPEC. Methods: Prospective feasibility study performed from January 2016 to December 2017. Twenty‐five patients with primary OC (FIGO III‐IV) received upfront or interval CRS combined with carboplatin HIPEC at dose 800 mg/m 2. Primary outcome measurements: grade 3 to 5 adverse events within 30 days according to Common Terminology Criteria for Adverse Events. Secondary outcome measurements: reoperation rate, length of hospital stay, readmission rate, and time from surgery to systemic chemotherapy administration. Results: No deaths (grade 5) or grade 4 adverse events were observed. Eleven patients (44.0%) experienced at least one grade 3 adverse event, the most common being an infection (28.0%) and neutropenia (12.0%). The reoperation rate was 8.0%. The median hospital stay was 14 days (range 9‐25 days), and five patients (25.0%) were readmitted within 30 days after surgery. Median time from surgery to the administration of the first dose of systemic chemotherapy was 41 days (range 24‐81 days). Conclusion: Our small‐scale prospective study supports that CRS and carboplatin HIPEC used for primary advanced‐stage OC is feasible with acceptable morbidity.

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“…The efficacy of HIPEC for peritoneal carcinomatosis treatment has been demonstrated for several cancers of digestive origin (colon, rectum, mesothelioma and peritoneal pseudomyxoma) and, in the last two decades its use has grown in importance for recurrent ovarian cancer management. Recent studies have demonstrated the feasibility of this approach for this indication, with acceptable morbidity and mortality . Fagotti et al.…”

Section: Discussionmentioning

confidence: 99%

“…For tumor cytoreduction, the postoperative prognosis is predominantly guided by the resection of organs and the presence of digestive sutures. Cascales Campos recently showed that the necessity of using digestive anastomoses constitutes an independent risk factor for grade 3 and grade 4 complications. In our study, the median number of anastomoses per patient was low and could partly explain the uneventful follow up.…”

Section: Discussionmentioning

confidence: 99%

Hyperthermic intraperitoneal chemotherapy for the treatment of recurrent ovarian cancer in elderly women

Delotte

Arias

Guérin

et al. 2015

Acta Obstet Gynecol Scand

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Our aim was to evaluate the morbidity and survival associated with combined cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of recurrent ovarian cancer for patients aged 70 years and older. We conducted a monocentric study in a French university hospital and collected data on 15 women aged ≥ 70 years, treated by cytoreduction and HIPEC for ovarian cancer relapse. The median overall survival was 35 months, with a median disease-free survival of 15.6 months. When a Peritoneal Cancer Index subgroup analysis was performed, a statistically significant difference in the disease-free survival could be observed for a Peritoneal Cancer Index ≤ 13 (p = 0.036). A trend towards improvement of disease-free survival was observed when the Completeness of Cytoreductive Score was equal to 0 (p = 0.0915).

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Morbidity and mortality outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with primary and recurrent advanced ovarian cancer

Cited by 50 publications

References 48 publications

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy to Treat Advanced/Recurrent Epithelial Ovarian Cancer: Results from a Retrospective Study on Prospectively Established Database

Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy to Treat Advanced/Recurrent Epithelial Ovarian Cancer: Results from a Retrospective Study on Prospectively Established Database

Morbidity after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy with carboplatin used for ovarian, tubal, and primary peritoneal cancer

Hyperthermic intraperitoneal chemotherapy for the treatment of recurrent ovarian cancer in elderly women

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