title: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in recurrent epithelial ovarian cancer with peritoneal metastases: a single centre experience.
abstract: BACKGROUND
  This investigation aims to assess morbidity, mortality and postoperative outcomes of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in recurrent epithelial ovarian cancer (REOC) with peritoneal metastases (PM).
  
  
  METHODS
  Consecutive patients with radiographic evidence of REOC with PM were scheduled for CRS and HIPEC at the Comprehensive Cancer Center, University Hospital Tübingen, Germany. Clinical data were retrospectively analyzed.
  
  
  RESULTS
  In total, 90 patients were analyzed. Complete cytoreduction and HIPEC could be performed in 69 % of patients. When categorizing patients with respect to the completeness of cytoreduction (CC-0/1 vs CC-2/3), there was no difference considering baseline demographic characteristics. Cumulative morbidity was 42 %. Morbidity rates did not statistically differ between CC-0/1 patients with HIPEC and CC-2/3 patients without HIPEC. No surgery-related and 90-day postoperative mortality was observed. In CC-0/1 patients, median overall survival was 35 months as opposed to 14 months in CC-2/3 patients. There was no difference in survival with respect to the peritoneal carcinomatosis index (PCI) as long as complete cytoreduction could be achieved.
  
  
  CONCLUSIONS
  CRS and HIPEC can be performed with acceptable morbidity and low mortality in specialized centres. Our data do not suggest that HIPEC necessarily increases the risk of postoperative adverse events.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University of Tübingen, Comprehensive Cancer Center, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany, ingmar.koenigsrainer@med.uni-tuebingen.de.
authors.forename: Ingmar
authors.initials: I
authors.lastname: Königsrainer
authors.forename: Philipp
authors.initials: P
authors.lastname: Horvath
authors.forename: Florian
authors.initials: F
authors.lastname: Struller
authors.forename: Eva Maria
authors.initials: EM
authors.lastname: Grischke
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Alfred
authors.initials: A
authors.lastname: Königsrainer
authors.forename: Stefan
authors.initials: S
authors.lastname: Beckert
mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007274:Injections, Intraperitoneal; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D009375:Neoplasms, Glandular and Epithelial / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D010052:Ovariectomy / Q000379:methods; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis