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

J Surg Oncol. 2019 Sep;120(3):550-557. doi: 10.1002/jso.25603. Epub 2019 Jul 2.

Abstract

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.

Keywords: complications; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; ovarian cancer.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Carboplatin / administration & dosage*
  • Carcinoma, Ovarian Epithelial / drug therapy
  • Carcinoma, Ovarian Epithelial / surgery
  • Carcinoma, Ovarian Epithelial / therapy*
  • Chemotherapy, Adjuvant
  • Cytoreduction Surgical Procedures / methods
  • Fallopian Tube Neoplasms / drug therapy
  • Fallopian Tube Neoplasms / surgery
  • Fallopian Tube Neoplasms / therapy*
  • Female
  • Humans
  • Hyperthermia, Induced / methods*
  • Middle Aged
  • Neoadjuvant Therapy
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / surgery
  • Ovarian Neoplasms / therapy*
  • Paclitaxel / administration & dosage
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / surgery
  • Peritoneal Neoplasms / therapy*
  • Prospective Studies

Substances

  • Carboplatin
  • Paclitaxel