HIPEC FOR RECURRENT OVARIAN CANCER

Gynecol Oncol. 2013 Dec 27. pii: S0090-8258(13)01392-9. doi: 10.1016/j.ygyno.2013.12.028. [Epub ahead of print]

Minimally invasive secondary cytoreduction plus HIPEC for recurrent ovarian cancer: A case series.

Fagotti A1, Petrillo M2, Costantini B2, Fanfani F3, Gallotta V2, Chiantera V4, Turco LC2, Bottoni C2, Scambia G2.

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Abstract

OBJECTIVE:

To analyze the feasibility of laparoscopic/robotic secondary cytoreductive surgery and hyperthermic intraperitoneal intra-operative chemotherapy (SCS+HIPEC) in a retrospective series of isolated platinum sensitive recurrent ovarian cancer.

METHODS:

We retrospectively evaluated a consecutive series of ovarian cancer patients with isolated platinum sensitive relapse. Isolated relapse was defined as the presence of a single nodule, in a single anatomic site. In all cases the presence of isolated relapse was assessed at pre-operative FDG-PET/CT scan, and confirmed with staging laparoscopy performed immediately before SCS+HIPEC.

RESULTS:

84 women with platinum sensitive relapse received SCS+HIPEC during a 4-year period. Among them, 10 cases (11.9%) showed isolated relapse and were treated with laparoscopic/robotic SCS+HIPEC. In all cases complete debulking was achieved. In HIPEC treatment, 9 women received cisplatin at 75mg/m2, and the remaining patient oxaliplatin 460mg/m2. In 7 patients SCS was performed through the laparoscopic route, and in 3 cases with a robotic approach. The median operative time from skin incision to the end of cytoreductive surgery was 122min (95-140), estimated blood loss was 50cm3 (50-100), and the median length of hospital stay was 4days (3-7). The interval from surgery to adjuvant chemotherapy was 21days (19-32). No grade 3/4 surgical, metabolic, or hematologic complications occurred. In all cases post-operative FDG-PET/CT scan was negative, and after a median time of 10months (6-37) from SCS+HIPEC no secondary recurrence was observed.

CONCLUSIONS:

Minimally invasive SCS+HIPEC can be safely performed in selected ovarian cancer patients with platinum sensitive isolated relapse.