Hyperthermic intraperitoneal chemotherapy with cisplatin and paclitaxel in advanced ovarian cancer: a multicenter prospective observational study.
OBJECTIVE
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been recently reported with favorable oncological outcomes as treatment of advanced epithelial ovarian cancer (EOC). The aim of this study was to demonstrate the feasibility of CRS+HIPEC with cisplatin and paclitaxel for the treatment of advanced EOC.


METHODS
This is a prospective observational study of 54 patients, from April 2007 to October 2013, with primary or recurrent peritoneal carcinomatosis due to EOC. The mean age was 54.51±9.34. Thirty patients (59%) had primary EOC, and 24 patients (41%) had recurrent disease.


RESULTS
Mean peritoneal cancer index was 10.11 (range, 0 to 28), complete cytoreduction (CC0) was achieved for 47 patients (87%), CC1 for seven patients (13%). Patients with suboptimal cytoreduction (CC2 and CC3) were not included in the study. The mean stay in intensive care unit was 4.73±5.51 days and the mean hospitalization time was 24.0±10.03 days. We did not observe any intraoperative death. Seven patients (13%) required additional operations. Three patients (5.6%) died within 30 days from the procedure. Severe complications were seen in 19 patients (35.2%). During the follow-up period, disease recurred in 33 patients (61.1%); the median disease-free survival time was 12.46 months and the median overall survival time was 32.91 months.


CONCLUSIONS
CRS+HIPEC with cisplatin and paclitaxel for advanced EOC is feasible with acceptable morbidity and mortality. Additional follow-up and further studies are needed to determine the effects of HIPEC on long term survival.
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Federico
F
Coccolini
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Luca
L
Campanati
Unit of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Fausto
F
Catena
Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Valentina
V
Ceni
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy. marco.ceresoli89@gmail.com.
Marco
M
Ceresoli
Unit of Gynaecology, Jena University Hospital, Jena, Germany.
Jorge
J
Jimenez Cruz
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Marco
M
Lotti
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Stefano
S
Magnone
University of Hawaii at Manoa, Honolulu, HI, USA.
Josephine
J
Napoli
Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Diego
D
Rossetti
Unit of Gynecologic Oncology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Pierandrea
P
De Iaco
Unit of Gynecologic Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Luigi
L
Frigerio
Unit of General, Emergency and Transplant Surgery, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Antonio
A
Pinna
Unit of Gynaecology, Jena University Hospital, Jena, Germany.
Ingo
I
Runnebaum
Unit of General Surgery I, Papa Giovanni XXIII Hospital, Bergamo, Italy.
Luca
L
Ansaloni
D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005240:Feasibility Studies; D006979:Hyperthermia, Induced / Q000009:adverse effects / Q000379:methods; D007263:Infusions, Parenteral; D053208:Kaplan-Meier Estimate; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000601:surgery; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D016896:Treatment Outcome
D002945:Cisplatin; D017239:Paclitaxel
Cisplatin; Disease-free Survival; Ovarian Neoplasms; Paclitaxel; Prospective studies