HIPEC in recurrent ovarian cancer patients: morbidity-related treatment and long-term analysis of clinical outcome

Gynecol Oncol. 2011 Aug;122(2):221-5. doi: 10.1016/j.ygyno.2011.04.008. Epub 2011 May 4.

Abstract

Objective: To evaluate morbidity and mortality rates associated with the use of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) after optimal cytoreduction (CRS) in a large single-institutional series of platinum-sensitive recurrent ovarian cancer patients. Moreover, disease free (DFS) and overall survival (OS) of previously studied patients have been assessed after a longer follow-up period.

Method: From May 2005 to October 2010, recurrent ovarian cancer patients with a platinum-free interval of at least 6 months have been prospectively enrolled in a protocol of CRS plus HIPEC with oxaplatinum (460 mg/m(2)) heated to 41.5 °C for 30 min, followed by 6 cycles of systemic chemotherapy with taxotere 75 mg/m(2) and oxaliplatin 100 mg/m(2).

Results: Forty-one patients experienced 43 procedures (CRS+HIPEC). An optimal cytoreduction was achieved in all cases (CC-0 95.3%; CC-1 4.7%). A complication rate of 34.8% was registered, with no case of intraoperative death or within 30 days after surgery. Survival curves have been calculated in a group of 25 patients with a minimum follow-up of 18 months, obtaining a median DFS and OS of 24 (range 6-60) and 38 months (range 18-60), respectively.

Conclusion: In recurrent platinum-sensitive ovarian cancer patients, the use of CRS plus HIPEC represents a safe treatment, able to significantly influence the survival rates compared to chemotherapy alone or surgery plus standard chemotherapy.

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Female
  • Humans
  • Hyperthermia, Induced / methods*
  • Injections, Intraperitoneal
  • Middle Aged
  • Morbidity
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / therapy*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / therapy*
  • Peritoneal Neoplasms / therapy*
  • Treatment Outcome