Different sequential approaches of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treating ovarian cancer with malignant ascites.
OBJECTIVE
Treatment for malignant ascites in advanced ovarian cancer (OC) patients remains controversial. The objective of this study was to investigate the efficacy of combined continuous circulatory hyperthermic intraperitoneal chemotherapy (HIPEC) preceded or followed by cytoreductive surgery (CRS) for malignant ascites in OC patients.


METHODS
Female OC patients (n = 32) with malignant ascites were divided based on stable (n = 17) or unstable (n = 15) vital signs. Stable patients were treated with CRS immediately followed by HIPEC (CRS + HIPEC). Unstable patients were treated using B-mode ultrasound-guided HIPEC followed by delayed CRS upon vital sign stability (HIPEC + dCRS). All patients were followed up until death or until December 2012.


RESULTS
Median follow-up was 29 months. All patients showed ascite regression [objective remission rates (ORR) = 100 %]. Among stable patients, CRS + HIPEC was successful in 14/17 (83.4 %). Among unstable patients, HIPEC + dCRS was successful in 13/15 (86.7 %). Median survival times were 19 and 17 months in the stable and unstable groups, respectively. No significant differences in CRS rates, ascites ORR, Karnofsky performance status scores, or survival rates were observed between groups (P > 0.05).


CONCLUSIONS
Cytoreductive surgery with immediate HIPEC and HIPEC with dCRS, determined by vital sign stability, may lead to similar outcomes in OC patients with malignant ascites.
Intracelom Hyperthermic Perfusion Therapy Center, Cancer Hospital of Guangzhou Medical College, Guangzhou, 510095, China, bamingchenmedsci12@126.com.
Mingchen
M
Ba
Hui
H
Long
Xiangliang
X
Zhang
Yunqiang
Y
Tang
Yinbing
Y
Wu
Feihong
F
Yu
Shuai
S
Wang
Shuzhong
S
Cui
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000601:surgery* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery* / Q000628:therapy*; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome