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

2014 ◽  
Vol 40 (8) ◽  
pp. 970-975 ◽  
Author(s):  
P. Cascales Campos ◽  
Jose Gil ◽  
Pascual Parrilla
2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jue Zhang ◽  
Xin-bao Li ◽  
Zhong-he Ji ◽  
Ru Ma ◽  
Wen-pei Bai ◽  
...  

Background. The mainstay of treatment for advanced ovarian cancer is debulking surgery followed by chemotherapy that includes carboplatin and paclitaxel, but the prognosis is poor. This study is aimed at evaluating the efficacy and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) as first-line surgical treatment in patients with advanced ovarian cancer (AOC). Methods. FIGO stage III/IV AOC patients underwent CRS+HIPEC as first-line surgical treatment at our center from December 2007 to January 2020. The primary endpoint was survival, and the secondary endpoint was safety. Results. Among 100 patients, the median Karnofsky performance status (KPS) score was 80 (50-100), median peritoneal cancer index (PCI) was 19 (1-39), median completeness of cytoreduction (CC) score was 1 (0-3), number of organ regions removed was 4 (3-9), number of peritoneal regions removed was 4 (1-9), and number of anastomoses was 1 (0-4). The median follow-up was 36.8 months; 75 (75.0%) patients were still alive, and 25 (25.0%) had died. The median overall survival (mOS) was 87.6 (95% CI: 72.1-103.0) months, and the 1-, 2-, 3-, 4-, and 5-year survival rates were 94.1%, 77.2%, 68.2%, 64.2%, and 64.2%, respectively. Univariate analysis showed that better mOS correlated with an age ≤, KPS ≥ 80 , ascites ≤ 1000  ml, PCI < 19 , and CC score 0-1. Multivariate Cox analysis showed that CC was an independent factor for OS; patients who underwent CRS with a CC score 0-1 had a mPFS of 67.8 (95% CI: 48.3-87.4) months. The perioperative serious adverse event and morbidity rates were 4.0% and 2.0%, respectively. Conclusions. CRS+HIPEC improves survival for AOC patients with acceptable safety at experienced high-volume centers. Stringent patient selection and complete CRS are key factors for better survival.


2019 ◽  
Vol 65 (1) ◽  
pp. 142-146
Author(s):  
Aleksey Shelekhov ◽  
Viktoriya Dvornichenko ◽  
Sergey Radostev ◽  
Rodion Rasulov ◽  
Dmitriy Morikov ◽  
...  

The first experience of cytoreductive surgery technology and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) usage in the practice of Irkutsk Regional Cancer Center. All subjects were divided into 2 groups: the group of clinical comparison - the patients after suboptimal cytoreduction (53 persons), and the main group - the patients after optimal or complete debulking operation and hyperthermic intraperitoneal chemotherapy in some cases (32 persons). The subjects had ovarian cancer. The indispensable prerequisite of picking was confirmed carcinomatous peritoneal spread, resectable process, overall status. The primary analysis assay included time factors such as preoperation period, operation time, postoperative bed-days, in plus, complications and their character in postoperative period. In the article there are statistics of disease-free and overall survival in all groups and full consistent outline of the intraoperative hyperthermic chemotherapy method. The research has prospective character, observation continued. Expected results will be significant difference of disease-free and overall survival in the groups of interest.


2010 ◽  
Vol 36 (10) ◽  
pp. 1030
Author(s):  
Claire de La Hosseraye ◽  
Reza Kianmanesh ◽  
Enrico Facchiano ◽  
Jean-Marc Sabate' ◽  
Benjamin Castel ◽  
...  

2021 ◽  
pp. ijgc-2021-002511
Author(s):  
Ali Ayhan ◽  
Safak Yilmaz Baran ◽  
Dogan Vatansever ◽  
Gulsen Dogan Durdag ◽  
Huseyin Akilli ◽  
...  

ObjectiveThis study aims to evaluate the effect of the COVID-19 pandemic and related restrictions on patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer.MethodsWe retrospectively evaluated ovarian cancer patients who underwent HIPEC following complete cytoreductive surgery performed during the outbreak of the COVID-19 pandemic in three different centers specializing in gynecological oncology. All patients who underwent cytoreduction plus HIPEC for a primary, interval, and recurrent surgery were evaluated. Primary outcomes was postoperative 30-day morbidity and mortality. The secondary outcome was infection of patient and/or related staff with COVID-19 during the perioperative or early postoperative period.ResultsWe performed a total of 35 HIPEC procedures during the pandemic: 15 (42.9%) patients underwent primary/interval surgery, while 20 (57.1%) patients had recurrent disease. Grade 3–4 complications occurred in one patient (2.9%) (chronic renal failure), while mortality did not occur in any patient. Neither the patients nor related staff were infected with the coronavirus during the perioperative or early postoperative period. One patient, who was diagnosed with COVID-19 pneumonia on postoperative day 80 died from the infection. Another patient died on postoperative day 85 due to progressive ovarian cancer, a disorder in vital functions, and organ failure.ConclusionHIPEC during the COVID-19 pandemic seems a safe and feasible procedure, with acceptable morbidity and mortality rates. Careful selection of patients is important and precautions should be taken before the procedure.


2021 ◽  
Author(s):  
Zahraa Alali ◽  
Max P. Horowitz ◽  
Danielle Chau ◽  
Lexie Trestan ◽  
Jing Hao ◽  
...  

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with interval cytoreductive surgery increases the overall survival of epithelial ovarian cancer (EOC) patients with advanced disease. Despite its proven benefits, the mechanism by which HIPEC extends overall survival remains unknown and current strategies to optimize HIPEC are therefore limited. A major challenge is the lack of a robust and streamlined model to investigate the mechanisms underlying HIPEC efficacy. Objective: To introduce a novel murine model that can be used to enhance our understanding of HIPEC therapy. Method: ID8-luc, an EOC mouse cell line, is inoculated into immunocompetent C57BL/6J mice intraperitoneally. Once tumor is detected by In Vivo Imaging System (IVIS), cisplatin (5 mg/kg) is injected intraperitoneally and superficial hyperthermia of 40C is applied to the animals abdomen and pelvis using an FDA-approved hyperthermia unit (BSD500) for 20 minutes. To validate the model, four treatment conditions were tested: cisplatin and hyperthermia, cisplatin and normothermia, vehicle and hyperthermia, and vehicle and normothermia. Tumor growth was assessed over the course of treatment using IVIS optical spectrum. Results: Tumor growth in mice treated with hyperthermic cisplatin was significantly suppressed compared to mice treated with normothermic cisplatin (p < 0.05). No significant differences in tumor growth were observed in the hyperthermic vehicle and normothermic vehicle groups. Conclusions: We developed an innovative noninvasive mouse model of HIPEC. Similar to patients with advanced ovarian cancer who are treated with HIPEC at the time of interval cytoreductive surgery, our model demonstrates that hyperthermia enhances the inhibitory effect of cisplatin on intraperitoneal tumor growth. Development of this murine model provides an opportunity to elucidate the mechanisms underlying HIPEC and offer an opportunity to test adjunct treatments in a pre-clinical setting to enhance the utility of HIPEC.


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