Intraoperative hyperthermic intraperitoneal chemotherapy after cytoreductive surgery in ovarian cancer peritoneal carcinomatosis: systematic review of current results.
BACKGROUND
Advanced and recurrent ovarian cancer results in extensive spread of tumor on the peritoneal surfaces of the abdomen and pelvis. We collectively review studies in the literature that report the efficacy of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer peritoneal carcinomatosis.


METHODS
An electronic search of all relevant studies published in peer-reviewed journals before May 2009 was performed on three databases. The quality of each study was independently assessed and classified according to the time point of HIPEC use in various setting of ovarian cancer from the consensus statement of the Peritoneal Surface Oncology Group. Clinical efficacy was synthesized through a narrative review with full tabulation of the results of each included study.


RESULTS
Nineteen studies each of more than ten patients reporting treatment results of HIPEC of patients with both advanced and recurrent ovarian cancer were included and data were extracted. All studies were observational case series. The overall rate of severe perioperative morbidity ranged from 0 to 40% and mortality rate varied from 0 to 10%. The overall median survival following treatment with HIPEC ranged from 22 to 64 months with a median disease-free survival ranging from 10 to 57 months. In patients with optimal cytoreduction, a 5-year survival rate ranging from 12 to 66% could be achieved.


CONCLUSIONS
Despite the heterogeneity of the studies reviewed, current evidence suggest that complete CRS and HIPEC may be a feasible option with potential benefits that are comparable with the current standard of care. A randomized trial is required to establish the role of HIPEC in ovarian cancer.
Chua
Terence C
TC
Department of Surgery, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia. Terence.Chua@unsw.edu.au
Robertson
Greg
G
Liauw
Winston
W
Farrell
Rhonda
R
Yan
Tristan D
TD
Morris
David L
DL
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002277:Carcinoma / Q000453:epidemiology / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007263:Infusions, Parenteral; D007430:Intraoperative Care / Q000379:methods*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010052:Ovariectomy / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D016896:Treatment Outcome
D000970:Antineoplastic Agents
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