scholarly journals Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy Improves Survival with Acceptable Safety for Advanced Ovarian Cancer: A Clinical Study of 100 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Jue Zhang ◽  
Xin-bao Li ◽  
Zhong-he Ji ◽  
Ru Ma ◽  
Wen-pei Bai ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Karnofsky Performance Status ◽  
Univariate Analysis ◽  
Advanced Ovarian Cancer ◽  
First Line

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.

scholarly journals Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei of Appendiceal Origin---801 Cases from a Single Institution in China

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ao Xia ◽  
Xichao Zhai ◽  
Lubiao An ◽  
Bing Wang ◽  
Guanjun Shi ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Univariate Analysis ◽  
Long Term Outcomes ◽  
Peritoneal Cancer ◽  
Tumor Debulking

Aim: As more and more centers has published their treatment results of pseudomyxoma peritonei (PMP) with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), the data from China is missing. Myxoma Department of Aerospace Hospital is the biggest center treating PMP in China. The purpose of this study is to report the early and long-term outcomes for PMP from this single center.Methods: 801 appendix-derived PMP out of 1008 consecutive patients treated in Myxoma Department of Aerospace Hospital between 2008 and 2019 were retrospectively analyzed.Results: Complete cytoreductive surgery (CCRS) was achieved in 240 (30%) patients with median PCI of 14(1~39), and the rest had maximal tumor debulking (MTD), HIPEC was implemented in 96.3% of CCRS and 78.6% of MTD. The major morbidity (grade III/IV) was 11.4% and the 30-day operative mortality is 0.7%. The 5- and 10-year OS of CCRS was 76.9% and 64.1%, which is significantly higher than MTD (5-, 10-year OS as 36.1%, 27.1%; p<0.001). On the univariate analysis, all prognostic factors (gender, PSS, interval time, prior chemotherapy, prior HIPEC, Peritoneal Cancer Index (PCI), completeness of cytoreduction (CC), HIPEC, pathology, present of serous ascites) were found to be associated with overall survival except for age. On multivariate analysis, only PCI>20, MTD, high pathologic grade and without HIPEC were independent factors predicting poorer prognosis.Conclusions: CCRS +HIPEC can benefit PMP well with controllable risks. MTD+HIPEC may benefit PMP as well when CCRS cannot be achieved after fully asscessment by an experienced peritoneal maglignacy center, but the surgery should be performed as limited as possible.

CYTOREDUCTIVE SURGERY IN THE TREATMENT OF ADVANCED OVARIAN CANCER: A COMPARATIVE ANALYSIS OF THE RESULTS

2019 ◽  
Vol 65 (1) ◽  
pp. 142-146
Author(s):  
Aleksey Shelekhov ◽  
Viktoriya Dvornichenko ◽  
Sergey Radostev ◽  
Rodion Rasulov ◽  
Dmitriy Morikov ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Advanced Ovarian Cancer ◽  
Operation Time ◽  
Cancer Center ◽  
Significant Difference ◽  
Disease Free

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.

Cytoreductive surgery associated with hyperthermic intraperitoneal chemotherapy in the treatment of advanced ovarian cancer

2010 ◽  
Vol 36 (10) ◽  
pp. 1030
Author(s):  
Claire de La Hosseraye ◽  
Reza Kianmanesh ◽  
Enrico Facchiano ◽  
Jean-Marc Sabate' ◽  
Benjamin Castel ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Advanced Ovarian Cancer

scholarly journals A Novel Non-Invasive Epithelial Ovarian Cancer Mouse Model Of Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

2021 ◽  
Author(s):  
Zahraa Alali ◽  
Max P. Horowitz ◽  
Danielle Chau ◽  
Lexie Trestan ◽  
Jing Hao ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Mouse Model ◽  
Tumor Growth ◽  
Epithelial Ovarian Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Murine Model ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Advanced Ovarian Cancer

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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