Cytoreductive surgery and intraoperative hyperthermic chemoperfusion for advanced ovarian carcinoma.
BACKGROUND
Optimal cytoreductive surgery combined with intraoperative hyperthermic chemoperfusion (IHCP) is a therapy that potentially could improve survival in a select group of patients with advanced ovarian cancer. The purpose of this study was to review the results of cytoreductive surgery and IHCP for advanced ovarian cancer and to identify factors that may predict which patients maximally benefit from this aggressive treatment.


METHODS
Patients treated with cytoreduction followed by IHCP for ovarian cancer were identified from an IHCP database from 1/2001 through 3/2004. Several factors including resection status, peritoneal cancer index (PCI), and prior surgery were evaluated for their ability to predict survival in our cohort of patients.


RESULTS
Thirteen patients with ovarian cancer treated with cytoreductive surgery followed by IHCP were identified. The 3-year overall survival rate for all thirteen patients was 55%. The median disease-free survival was 15.4 months (3-year disease-free survival, 11%). Several factors including PCI score (<6), ability to resect all gross disease, and previous surgical exploration appeared to impart an overall survival advantage.


CONCLUSIONS
The use of IHCP coupled with optimal cytoreduction is a safe and effective treatment for advanced ovarian carcinoma. However, the proper selection of patients who will benefit most from the therapy is essential for the success of the treatment.
Reichman
Trevor W
TW
Division of Surgical Oncology, UMDNJ-New Jersey Medical School, New Jersey 07903, USA.
Cracchiolo
Bernadette
B
Sama
Jahir
J
Bryan
Margarette
M
Harrison
Jonathan
J
Pliner
Lillian
L
Harrison
Lawrence E
LE
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D007430:Intraoperative Care; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D010052:Ovariectomy / Q000379:methods*; D018579:Patient Selection; D015996:Survival Rate; D016896:Treatment Outcome
D000970:Antineoplastic Agents