Intraperitoneal chemotherapy by ultrasound-guided direct puncture in recurrent ovarian cancer: feasibility, compliance, and complications.
OBJECTIVE
This prospective pilot study investigated the feasibility, complications, and compliance of the administration of intraperitoneal (IP) chemotherapy by direct puncture under ultrasonographic guidance performed on consecutive patients with recurrent ovarian cancer (ROC).


METHODS
Patients were evaluated to undergo secondary cytoreduction and/or to receive IP chemotherapy. Patients received standard intravenous therapy for ROC plus IP administration by direct puncture needle, under ultrasonographic guidance.


RESULTS
From January 2008 to January 2011, 38 patients were enrolled. A total of 402 IP procedures were performed, with a mean of 10.5 procedures per patient. The feasibility rate was 97.4%. In 237 cases (98.8%) of subgroup 1 (abdominal wall thickness ≤6 cm), the procedure was performed after 1 attempt, meanwhile in 6% of cases of subgroup 2 (abdominal wall thickness >6 cm), more than 1 attempt was necessary (P < 0.01). The mean procedure time was 10 minutes (range, 5-30 minutes). We recorded a total of 2.25% mild intraprocedure complications. No significant difference was identified for the complication rate according to the abdominal wall thickness or according to the number of previous laparotomies. A total of 5 procedures (1.2%) were not performed as a result of patients' noncompliance. The mean pain score according to the visual analog pain scale was moderate at the first evaluation (after 3 minutes) and mild at the final evaluation (after 10 minutes).


CONCLUSIONS
The administration of IP chemotherapy with a direct puncture, under ultrasound guidance, for patients with ROC, is a safe and feasible method, with a high acceptance from patients.
Department of Gynaecology and Obstetrics, Sapienza University of Rome, Rome, Italy.
Pierluigi
P
Benedetti-Panici
Giorgia
G
Perniola
Claudia
C
Marchetti
Milena
M
Pernice
Cristina
C
Donfrancesco
Violante
V
Di Donato
Federica
F
Tomao
Innocenza
I
Palaia
Marialida
M
Graziano
Stefano
S
Basile
Filippo
F
Bellati
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002945:Cisplatin / Q000008:administration & dosage*; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007274:Injections, Intraperitoneal; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010349:Patient Compliance; D010865:Pilot Projects; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data*; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine