[Secondary debulking surgery and intraperitoneal chemotherapy in advanced or recurrent epithelial ovarian cancer].
OBJECTIVE
The aim of this study was to evaluate the indications and the results of secondary cytoreduction surgery with intraperitoneal (i.p.) paclitaxel chemotherapy in advanced or recurrent epithelial ovarian cancer.


METHODS
In a retrospective study, records were reviewed for 13 patients who received i.p. paclitaxel therapy (175 mg/m2) during secondary cytoreductive surgery or surgery for recurrent disease. All these patients were initially treated with optimal debulking surgery (macroscopic persistent residual disease) and systemic chemotherapy.


RESULTS
Nine patients were operated for secondary cytoreductive surgery (group I) and four patients operated for recurrent disease (group II). Postoperative residual disease was absent or microscopic in 69% (n = 9). Median hospital stay was 16 days. Hematologic toxicity grade III-IV was reported by 12 patients (92%). Operative mortality was 7.7% (n = 1). Median follow-up was 22.7 months. The median overall survival was 25.5 months. The median disease-free survival was 8.5 months. The median disease-free survival for group I and II were respectively 11.7 months and 4.2 months (P = 0.3). Progression of disease after completion of treatment was documented in 62% (n = 8): six patients for group I and two patients for group II.


CONCLUSIONS
Secondary cytoreduction surgery associated with intraperitoneal chemotherapy is feasible after adjuvant systemic chemotherapy for patients with recurrent or suboptimally resected ovarian cancer. Results on loco-regional control for recurrent disease are poor. Intraperitoneal chemotherapy should be discussed during a two-step surgical strategy, as secondary cytoreductive surgery.
Plaisant
N
N
Département de chirurgie oncologique, CRLC Val-d'Aurelle, 208, rue des Apothicaires, parc Euromédecine, 34298 Montpellier 5, France.
Quenet
F
F
Fabbro
M
M
Gourgou
S
S
Gutowski
M
M
Saint-Aubert
B
B
Rouanet
P
P
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000601:surgery*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D010537:Peritoneum / Q000187:drug effects; D015996:Survival Rate
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel