Outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal surface dissemination from ovarian neoplasms

Am J Surg. 2011 Oct;202(4):481-6. doi: 10.1016/j.amjsurg.2011.02.004. Epub 2011 Apr 7.

Abstract

Background: Few data exist on the treatment of peritoneal surface dissemination (PSD) from ovarian cancer (OC) with hyperthermic intraperitoneal chemotherapy (HIPEC). This work represents a review of the authors' institution's experience with HIPEC for PSD from OC.

Methods: Fifty-one patients with OC treated with HIPEC between 1996 and 2009 were identified in a prospectively managed database. All patients underwent maximal tumor debulking followed by HIPEC with mitomycin C, carboplatin, or paclitaxel.

Results: The median survival in this cohort was 29 months. When stratified by resection status, patients undergoing R0 and R1 resections experienced longer median survival than those who underwent R2 resections (47 vs 12 months, P = .0002). Intraoperative blood loss ≤ 400 mL resulted in greater 5-year survival than blood loss > 400 mL (60% vs 15%, P = .025).

Conclusions: This experience demonstrates that long-term survival is anticipated in patients who undergo complete cytoreduction followed by HIPEC for PSD from OC. These findings not only highlight the potential utility of HIPEC in the treatment of OC but also underscore the importance of maximal cytoreduction followed by HIPEC in this cohort of patients.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Carboplatin / administration & dosage
  • Chemotherapy, Cancer, Regional Perfusion*
  • Combined Modality Therapy
  • Databases, Factual
  • Female
  • Humans
  • Hyperthermia, Induced
  • Infusions, Parenteral
  • Middle Aged
  • Mitomycin / administration & dosage
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / surgery
  • Ovarian Neoplasms / therapy*
  • Paclitaxel / administration & dosage
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / surgery
  • Peritoneal Neoplasms / therapy*
  • Peritoneum / pathology
  • Peritoneum / surgery*

Substances

  • Mitomycin
  • Carboplatin
  • Paclitaxel