Hyperthermic intraperitoneal chemotherapy with oxaliplatin and without adjuvant chemotherapy in stage IIIC ovarian cancer.
OBJECTIVE
To assess the feasibility and efficacy of cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) without adjuvant chemotherapy for relapsed or persistent advanced ovarian cancer.


METHODS
This observational study included stage IIIC ovarian cancer patients due to undergo CRS (interval debulking or recurrent surgery) followed by HIPEC with oxaliplatin (460 mg/m2) for 30 min.


RESULTS
Twenty-two patients (12 interval debulking procedures and 10 recurrence procedures) were enrolled between September 2003 and September 2007. HIPEC was not performed in four patients because of operative findings. No patient received adjuvant chemotherapy after HIPEC. Patients were followed up routinely until recurrence or death. Median peritoneal cancer index at surgery was 6 (range: 1-18). Before HIPEC, all patients had completeness of cytoreduction scores of 0 or 1. Median length of hospital stay was 21 days (range 13-65). Ten patients (55.6%) had CTCAE grade 3-4 toxicity, including three patients (16.7%) requiring reoperation. No postoperative mortality was observed. With a median follow-up of 38 months (CI 95% 23.8-39.2), median overall survival was not reached. The 3-year overall survival rate was 83% (CI 95% 54-95). Median disease-free survival was, respectively, 16.9 months (CI 95% 10.2-23.2) and 10 months (CI 95% 4.5-11.3) for patients undergoing interval debulking or recurrence surgery.


CONCLUSIONS
HIPEC without adjuvant chemotherapy is both feasible and safe, but with a high rate of grade 3-5 toxicity. Survival results are encouraging but should be confirmed in a randomized trial.
Carrabin
N
N
Centre Léon-Bérard, Department of Surgical Oncology, 28, rue Laennec, 69008 Lyon, France. nicolas.carrabin@yahoo.fr
Mithieux
F
F
Meeus
P
P
Trédan
O
O
Guastalla
J-P
JP
Bachelot
T
T
Labidi
S I
SI
Treilleux
I
I
Rivoire
M
M
Ray-Coquard
I
I
D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D007263:Infusions, Parenteral; D007902:Length of Stay; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009944:Organoplatinum Compounds / Q000008:administration & dosage*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000077150:Oxaliplatin; D015996:Survival Rate
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin