The role of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal carcinomatosis in recurrent ovarian cancer.

Abstract

BACKGROUND AND OBJECTIVES:

Peritoneal carcinomatosis in women frequently has an ovarian origin. Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) along with radical surgery/peritonectomy could present a new therapeutic approach with curative intention. The purpose of this research is to evaluate the role of the administration of HIPEC.

METHODS:

A series of patients (N=26) diagnosed with peritoneal carcinomatosis for recurrent epithelial ovarian cancer (stage III) from January 1997 to December 2004 submitted to radical surgery/peritonectomy with optimal cytoreduction (R0-R1) were included in this study, 14 treated with HIPEC and 12 without HIPEC.

RESULTS:

The variables age, histologic type, peritonectomy procedures, peritoneal cancer index (PCI) and lymph node affectation were similar in both groups. The 5-year global survival was 58% and 17% (p=0.046), and 67% and 29% in patients with maximal cytoreduction (R0) (p=0.264), in the HIPEC- and non-HIPEC-treated patients, respectively. In patients with optimal cytoreduction and partial peritonectomy, 5-year global survival was also superior in the HIPEC group (75% vs. 11%, p=0.011). Average time free of disease was superior in the HIPEC group (48+/-42 vs. 24+/-21 months), with less reinterventions due to a new reappearance during the first three evolutionary years (2/14 vs. 4/12). Postoperative morbidity did not show substantial differences in both groups and there was no surgical mortality.

CONCLUSIONS:

HIPEC is a complement to radical surgery/ peritonectomy, which has been shown to be a surgical procedure with high tolerability, low morbimortality, enhanced survival and prolonged disease-free interval in patients with peritoneal carcinomatosis for recurrent ovarian cancer.

• Authors: Francisco C Muñoz-Casares, Sebastián Rufián, María J Rubio, Carlos J Díaz, Rafael Díaz, Angela Casado, Alvaro Arjona, María C Muñoz-Villanueva, Jordi Muntané
• Journal: Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico (Clin Transl Oncol) Vol. 11 Issue 11 Pg. 753-9 (Nov 2009) ISSN: 1699-3055 [Electronic] Italy
• PMID: 19917539 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Disease-Free Survival
• Female
• Humans
• Hyperthermia, Induced (methods)
• Infusions, Parenteral (methods)
• Lymphatic Metastasis
• Middle Aged
• Ovarian Neoplasms (drug therapy, pathology, therapy)
• Peritoneal Neoplasms (drug therapy, pathology, therapy)
• Recurrence
• Time Factors
• Treatment Outcome