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The Short-term Results of Cytoreduction+Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Patients With Grade IIIC and IV Ovarian Cancer

Year 2021, Volume: 6 Issue: 3, 138 - 143, 09.12.2021

Abstract

Aim: Cytoreductive surgery (CRS) applied together with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to prolong survival in advanced stage ovarian cancer. The aim of this study was to present the short-term results of patients with primary and recurrent advanced stage ovarian cancer applied with CRS+HIPEC in a single centre.
Methods: A retrospective examination was made of 18 patients with a diagnosis of advanced stage ovarian cancer applied with CRS+HIPEC in a single centre between May 2019 and March 2020. A record was made for each patient of demographic data, CA125 values, peritoneal carcinomatosis index (PCI), completeness of cytoreduction score (CC), surgical procedures applied to the patient, complications, disease-free survival (DFS) and overall survivial (OS).
Results: In the group with PCI ≥10, DFS was 18 months, and OS was 19 months, and the group with PCI ≤9, DFS and OS were found to be 20 months. No significant difference was determined between the two groups in respect of DFS and OS (p>0.05). In patients with CC0, DFS and OS were calculated as 20 months, and in those with CC1+CC2, DFS was 12 months and OS was 13.2 months. A statistically significant difference was determined between the two groups in respect of DFS and OS (p>0.05).
Conclusion: The study results demonstrated that optimal CRS applied together with HIPEC to patients with advanced stage ovarian cancer prolonged survival. The operations of these patients should be performed by experienced surgical oncology and gynaecology oncology surgery specialists.

References

  • 1. Bray F, Ferlay J, Soerjomataram I, Siegel RE, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A cancer journal for clinicians. 2018;68:394-424.
  • 2. Kurman RJ, Shih Ie M. Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer shifting the paradigm. Hum Pathol. 2011;42:918-31.
  • 3. Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohammed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130:107-14.
  • 4. Bijelic L, Jonson A, Sugarbaker PH. Systematic review of cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis in primary and recurrent ovarian cancer. Annals of Onco Off J Eur Soc Med Oncol. 2007;18:1943-50.
  • 5. Sugarbaker PH. Peritonectomy procedures. Cancer Treat Res. 1996;82:235-53.
  • 6. Sugarbaker PH. Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol. 2015;14:254-61.
  • 7. Zanon C, Clara R, Chiappino I, Bortolini M, Cornaglia S, Simone P, et al. Cytoreductive surgery and intraperitoneal chemohyperthermia for recurrent peritoneal carcinomatosis from ovarian cancer. World J Surg. 2004;28:1040-5.
  • 8. Piso P, Dahlke MH, Loss M, Schlitt HJ. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from ovarian cancer. World J Surg. Oncol. 2004;2:1-7.
  • 9. Kim JH, Lee JM, Ryu SK, Lee YS, Park YG, Hur SY, et al. Consolidation hyperthermic intraperitoneal chemotherapy using paclitaxel in patients with epithelial ovarian cancer. Journal of surgical oncology. 2010;101:149-55.
  • 10. Younan R, Kusamura S, Baratti D, Cloutier AS, Deraco M. Morbidity, toxicity, and mortality classification systems in the local regional treatment of peritoneal surface malignancy. J Surg Oncol. 2008;98:253-7.
  • 11. Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat. Res. 1996;82:359-74.
  • 12. Sugarbaker P, Chang D. Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol. 1999;6:727-31.
  • 13. Spiliotis J, Halkia E, Roukos DH. Ovarian cancer screening and peritoneal carcinomatosis: standards, ‘‘omics’’ and miRNAs for personalized management. Expert Rev Mol Diagn. 2011;11:465-7.
  • 14. Le Brun JF, Campion L, Berton-Rigaud D, Lorimier G, Marchall F, Ferron G, et al. Survival benefit of hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer: a multi-institutional case control study. Annals of surgical oncology. 2014;21:3621-7.
  • 15. Di Giorgio A, De Iaco P, De Simone M, Garofalo A, Scambia G, Pinna AD, et al. Cytoreduction (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced ovarian cancer: retrospective Italian multicenter observational study of 511 cases. Annals of surgical oncology. 2017;24:914-22.
  • 16. Mendivil AA, Rettenmaier MA, Abaid LN, Brown JV, Mori KM, Lopez KL, et al. Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: a 3 year experience. Cancer chemotherapy and pharmacology. 2017;80:405-10.
  • 17. Spiliotis J, Halkia E, Lianos E, Kalantzi N, Grivas A, Efstathiou E, et al. Cytoreductive surgery and HIPEC in recurrent epithelial ovarian cancer: a prospective randomized phase III study. Annals of surgical oncology. 2015;225:1570-5.
  • 18. Baiocchi G, Ferraira FO, Mantoan H, Anastacio De Costa AAB, Faloppa CC, Kumagai LY, et al. Hyperthermic intraperitoneal chemotherapy after secondary cytoreduction in epithelial ovarian cancer: a single-center comparative analysis. Annals of surgical oncology. 2016;23:1294-301.
  • 19. Yan TD, Deraco M, Baratti D, Kusamura S, Elias D, Glehen O, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol. 2009;27:6237-42.
  • 20. Alexander HR, Bartlett DL, Pingpank JF, Libutti SK, Royal R, Hughes MS, et al. Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma. Surgery. 2013;153:779-86.
  • 21. Halkia E, Spiliotis J, Sugarbaker P. Diagnosis and management of peritoneal metastases from ovarian cancer. Gastroenterol Res Pract. 2012;2012:541842.
  • 22. Gasimli K, Braicu E, Richter R,Chekerov R, Sehouli J. Prognostic and predictive value of the peritoneal cancer index in primary advanced epithelial ovarian cancer patients after complete cytoreductive surgery: study of tumor bank ovarian cancer. Annals of surgical oncology. 2015;22:2729-37.
  • 23. Sugarbaker PH. Technical Handbook for the Integration of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy into the Surgical Management of Gastrointestinal and Gynecologic Malignancy. Michigan, Ludann Company: 2005. p. 12-24.

Evre IIIC ve IV Over Kanserli Hastalarda Kısa Dönem Sitoredüksiyon + Hipertermik İntraperitoneal Kemoterapi (HIPEC) Sonuçlarımız

Year 2021, Volume: 6 Issue: 3, 138 - 143, 09.12.2021

Abstract

Amaç: İleri evre over kanserinde sitoredüktif cerrahi (CRS) ile birlikte yapılan Hipertermik İntraperitoneal Kemoterapi (HIPEC)’nin sağkalımı artırdığı gösterilmiştir. Bu çalışmada; tek merkezde primer ve rekürren ileri evre over kanseri tanısı ile CRS+HIPEC yapılan hastaların erken dönem sonuçlarını sunmayı amaçladık. Yöntemler: Mayıs-2019 ile mart-2020 tarihleri arasında tek merkezde ileri evre over kanseri tanısı ile CRS +HIPEC yapılan hastaların sonuçları retrospektif olarak incelendi. Hastaların; demografik verileri, preopereatif CA125 değerleri, petitoneal karsinomatozis indexi (PCI), comleteness of cytoreduction skoru (CC), hastalara yapılan cerrahi işlemler ve komplikasyonları, postoperatif takip süreleri, hastalıksız sağkalım (DFS) ve genel sağkalım (OS) süreleri kayıt altına alındı.
Bulgular: PCI≥10 olan grupta DFS 18 ay, OS 19 ay iken, PCI≤9 olan grupta DFS ve OS 20 ay olarak bulunmuştur. İki grup arasında DFS ve OS’de anlamlı fark yoktur (p>0,05). CC0 olanlarda DFS ve OS 20 ay, CC1+CC2’de ise DFS 12 ay, OS 13,2 ay olarak hesaplanmıştır. İki grup arasında DFS ve OS’de istatistiksel anlamlı fark mevcuttur (p<0,05). Sonuç: İleri evre over kanserlerinde optimal CRS ile birlikte yapılan HIPEC’in sağkalımı uzattığını düşünüyoruz. Bu hastaların operasyonlarının deneyimli cerrahi onkoloji ve jinekolojik onkoloji cerrahisi uzmanları tarafından yapılması gerektiği görüşündeyiz.

References

  • 1. Bray F, Ferlay J, Soerjomataram I, Siegel RE, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A cancer journal for clinicians. 2018;68:394-424.
  • 2. Kurman RJ, Shih Ie M. Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer shifting the paradigm. Hum Pathol. 2011;42:918-31.
  • 3. Lowe KA, Chia VM, Taylor A, O’Malley C, Kelsh M, Mohammed M, et al. An international assessment of ovarian cancer incidence and mortality. Gynecol Oncol. 2013;130:107-14.
  • 4. Bijelic L, Jonson A, Sugarbaker PH. Systematic review of cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis in primary and recurrent ovarian cancer. Annals of Onco Off J Eur Soc Med Oncol. 2007;18:1943-50.
  • 5. Sugarbaker PH. Peritonectomy procedures. Cancer Treat Res. 1996;82:235-53.
  • 6. Sugarbaker PH. Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol. 2015;14:254-61.
  • 7. Zanon C, Clara R, Chiappino I, Bortolini M, Cornaglia S, Simone P, et al. Cytoreductive surgery and intraperitoneal chemohyperthermia for recurrent peritoneal carcinomatosis from ovarian cancer. World J Surg. 2004;28:1040-5.
  • 8. Piso P, Dahlke MH, Loss M, Schlitt HJ. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from ovarian cancer. World J Surg. Oncol. 2004;2:1-7.
  • 9. Kim JH, Lee JM, Ryu SK, Lee YS, Park YG, Hur SY, et al. Consolidation hyperthermic intraperitoneal chemotherapy using paclitaxel in patients with epithelial ovarian cancer. Journal of surgical oncology. 2010;101:149-55.
  • 10. Younan R, Kusamura S, Baratti D, Cloutier AS, Deraco M. Morbidity, toxicity, and mortality classification systems in the local regional treatment of peritoneal surface malignancy. J Surg Oncol. 2008;98:253-7.
  • 11. Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat. Res. 1996;82:359-74.
  • 12. Sugarbaker P, Chang D. Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol. 1999;6:727-31.
  • 13. Spiliotis J, Halkia E, Roukos DH. Ovarian cancer screening and peritoneal carcinomatosis: standards, ‘‘omics’’ and miRNAs for personalized management. Expert Rev Mol Diagn. 2011;11:465-7.
  • 14. Le Brun JF, Campion L, Berton-Rigaud D, Lorimier G, Marchall F, Ferron G, et al. Survival benefit of hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer: a multi-institutional case control study. Annals of surgical oncology. 2014;21:3621-7.
  • 15. Di Giorgio A, De Iaco P, De Simone M, Garofalo A, Scambia G, Pinna AD, et al. Cytoreduction (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced ovarian cancer: retrospective Italian multicenter observational study of 511 cases. Annals of surgical oncology. 2017;24:914-22.
  • 16. Mendivil AA, Rettenmaier MA, Abaid LN, Brown JV, Mori KM, Lopez KL, et al. Consolidation hyperthermic intraperitoneal chemotherapy for the treatment of advanced stage ovarian carcinoma: a 3 year experience. Cancer chemotherapy and pharmacology. 2017;80:405-10.
  • 17. Spiliotis J, Halkia E, Lianos E, Kalantzi N, Grivas A, Efstathiou E, et al. Cytoreductive surgery and HIPEC in recurrent epithelial ovarian cancer: a prospective randomized phase III study. Annals of surgical oncology. 2015;225:1570-5.
  • 18. Baiocchi G, Ferraira FO, Mantoan H, Anastacio De Costa AAB, Faloppa CC, Kumagai LY, et al. Hyperthermic intraperitoneal chemotherapy after secondary cytoreduction in epithelial ovarian cancer: a single-center comparative analysis. Annals of surgical oncology. 2016;23:1294-301.
  • 19. Yan TD, Deraco M, Baratti D, Kusamura S, Elias D, Glehen O, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol. 2009;27:6237-42.
  • 20. Alexander HR, Bartlett DL, Pingpank JF, Libutti SK, Royal R, Hughes MS, et al. Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma. Surgery. 2013;153:779-86.
  • 21. Halkia E, Spiliotis J, Sugarbaker P. Diagnosis and management of peritoneal metastases from ovarian cancer. Gastroenterol Res Pract. 2012;2012:541842.
  • 22. Gasimli K, Braicu E, Richter R,Chekerov R, Sehouli J. Prognostic and predictive value of the peritoneal cancer index in primary advanced epithelial ovarian cancer patients after complete cytoreductive surgery: study of tumor bank ovarian cancer. Annals of surgical oncology. 2015;22:2729-37.
  • 23. Sugarbaker PH. Technical Handbook for the Integration of Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy into the Surgical Management of Gastrointestinal and Gynecologic Malignancy. Michigan, Ludann Company: 2005. p. 12-24.
There are 23 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Original Research
Authors

Mehmet Esat Duymuş 0000-0002-0372-7999

Hulya Ayik 0000-0002-3028-7247

Publication Date December 9, 2021
Published in Issue Year 2021 Volume: 6 Issue: 3

Cite

Vancouver Duymuş ME, Ayik H. The Short-term Results of Cytoreduction+Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Patients With Grade IIIC and IV Ovarian Cancer. Arch Clin Exp Med. 2021;6(3):138-43.