title: Intraperitoneal chemotherapy hyperthermia (HIPEC) for peritoneal carcinomatosis of ovarian cancer origin by fluid and CO2 recirculation using the closed abdomen technique (PRS-1.0 Combat): A clinical pilot study.
abstract: Background This paper reports a study of 21 patients with peritoneal carcinomatosis from ovarian cancer who underwent cytoreductive surgery and HIPEC by means of PRS-1.0 Combat®, a new model for closed abdomen HIPEC aimed at improving fluid distribution with assistance from a CO2 recirculation system. This new technology has been previously shown to be successful in an experimental study (pig model) performed by our group, and has been approved for use in our hospital. Methods Twenty-one patients with peritoneal carcinomatosis of ovarian cancer origin were included in the study. Cytoreductive surgery and HIPEC were performed by a closed abdomen fluid and CO2 recirculation technique using the PRS-1.0 Combat(®) model. We analysed the intraoperative safety tolerance and post-operative morbidity and mortality during the first 30 days. Results Between November 2011 and March 2014 21 patients with epithelial ovarian cancer, International Federation of Gynecology and Obstetrics stage II-IV, were included in the study. During the procedure there were no significant haemodynamic or analytical disturbances. Complication rates were 38.1% and 57.14% for grade III/IV and minor (grade I/II) complications, respectively. Post-operative mortality was 4.76% (one patient). Complete cytoreductive surgery and intraperitoneal chemotherapy improved overall survival and disease-free survival in women with advanced ovarian cancer. The association of intra-abdominal hyperthermia with chemotherapy (HIPEC) increased the therapeutic benefit. Conclusions This study has shown that closed abdomen intraperitoneal chemohyperthermia by a fluid and CO2 recirculation system (PRS-1.0 Combat(®)) can be a safe and feasible model for the treatment of peritoneal carcinomatosis of ovarian cancer origin.
authors.affiliation: a General Surgery Department , University General Hospital , Ciudad Real , Spain ;
authors.forename: Susana
authors.initials: S
authors.lastname: Sánchez-García
authors.affiliation: b General Surgery Department , University General Hospital , Ciudad Real , Spain ;
authors.forename: Pedro
authors.initials: P
authors.lastname: Villarejo-Campos
authors.affiliation: b General Surgery Department , University General Hospital , Ciudad Real , Spain ;
authors.forename: David
authors.initials: D
authors.lastname: Padilla-Valverde
authors.affiliation: c Deparment of Mathematics , University of Castilla la Mancha , Spain.
authors.forename: Mariano
authors.initials: M
authors.lastname: Amo-Salas
authors.affiliation: b General Surgery Department , University General Hospital , Ciudad Real , Spain ;
authors.forename: Jesús
authors.initials: J
authors.lastname: Martín-Fernández
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000627:therapeutic use; D002245:Carbon Dioxide; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D017239:Paclitaxel / Q000008:administration & dosage* / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000601:surgery / Q000628:therapy*; D010865:Pilot Projects
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D002245:Carbon Dioxide; D017239:Paclitaxel
keywords: Ovarian cancer; closed abdomen HIPEC