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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in recurrent epithelial ovarian cancer with peritoneal metastases: a single centre experience.

Published on Jun 1, 2014in Langenbeck's Archives of Surgery2.093
· DOI :10.1007/s00423-014-1207-5
Ingmar Königsrainer20
Estimated H-index: 20
(University of Tübingen),
Philipp Horvath6
Estimated H-index: 6
(University of Tübingen)
+ 4 AuthorsStefan Beckert17
Estimated H-index: 17
(University of Tübingen)
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).
  • References (21)
  • Citations (11)
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References21
Newest
#1Kenneth Jaaback ('JHCH': John Hunter Hospital)H-Index: 4
#2N Johnson (RUH: Royal United Hospital)H-Index: 13
Last. Theresa A Lawrie (RUH: Royal United Hospital)H-Index: 21
view all 3 authors...
Background Ovarian cancer tends to be chemosensitive and confine itself to the surface of the peritoneal cavity for much of its natural history. These features have made it an obvious target for intraperitoneal (IP) chemotherapy. Chemotherapy for ovarian cancer is usually given as an intravenous (IV) infusion repeatedly over five to eight cycles. Intraperitoneal chemotherapy is given by infusion of the chemotherapeutic agent directly into the peritoneal cavity. There are biological reasons why t...
200 CitationsSource
#1Naoual Bakrin (University of Lyon)H-Index: 14
#2Bereder JmH-Index: 15
Last. Olivier Glehen (University of Lyon)H-Index: 46
view all 18 authors...
Abstract Background Despite a high response rate to front-line therapy, prognosis of epithelial ovarian carcinoma (EOC) remains poor. Approaches that combine Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) have been developed recently. The purpose of this study was to assess early and long-term survival in patients treated with this strategy. Patients and methods A retrospective cohort multicentric study from French centres was performed. All consecutive patient...
128 CitationsSource
#1P. HarterH-Index: 21
#2Sven MahnerH-Index: 31
Last. Uwe WagnerH-Index: 29
view all 9 authors...
HIPEC is offered to patients with ovarian, fallopian tube or primary peritoneal cancer at some hospitals. Altogether, there is still no evidence that HIPEC leads to an improvement of prognosis in any gynecologic tumor, neither in primary therapy nor in treatment of relapse. The available data indicate an increased complication rate which might negatively impact the benefit-risk balance of this procedure. In addition, standard treatment with proven efficacy might be withheld due to application of...
13 CitationsSource
#1Ingmar Königsrainer (University of Tübingen)H-Index: 20
#2Stefan Beckert (University of Tübingen)H-Index: 17
Last. Alfred Königsrainer (University of Tübingen)H-Index: 43
view all 11 authors...
Purpose Peritoneal recurrence of ovarian cancer is frequent after primary surgery and chemotherapy and has poor long-term survival. De novo cytoreductive surgery is crucial with the potential to improve prognosis, especially when combined with hyperthermic intraperitoneal chemotherapy (HIPEC).
13 CitationsSource
PURPOSE: Ovarian cancer is the leading cause of death from gynecological cancer. The current treatment of this type of cancer consists of cytoreductive surgery (CRS) and systemic chemotherapy. The aim of this study was to examine if the hyperthermic intraoperative chemotherapy (HIPEC) is an alternative modality to treat this category of patients along with a second attempt of surgical resection and second or third line systemic chemotherapy. METHODS: Forty-eight patients suffering from advanced ...
35 Citations
#1Dominique Elias (Institut Gustave Roussy)H-Index: 82
Last. Olivier GlehenH-Index: 46
view all 9 authors...
Purpose Peritoneal carcinomatosis (PC) from colorectal cancer traditionally is considered a terminal condition. Approaches that combine cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC) have been developed recently. The purpose of this study was to assess early and long-term survival in patients treated with that strategy. Patients and Methods A retrospective-cohort, multicentric study from French-speaking countries was performed. All consecutive patients with PC f...
549 CitationsSource
#1Terence C. Chua (UNSW: University of New South Wales)H-Index: 35
#2Winston Liauw (UNSW: University of New South Wales)H-Index: 28
Last. David L. Morris (UNSW: University of New South Wales)H-Index: 65
view all 8 authors...
20 CitationsSource
#1Dennis S. Chi (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 60
#2Eric L. Eisenhauer (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 22
Last. Richard R. Barakat (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 65
view all 10 authors...
Abstract Objective To determine the impact on progression-free survival (PFS) and overall survival (OS) of a programmatic change in surgical approach to advanced epithelial ovarian cancer. Methods Two groups of patients with stage IIIC and IV ovarian, tubal, and peritoneal carcinoma were compared. Group 1, the control group, consisted of all 168 patients who underwent primary cytoreduction from 1/96 to 12/99. Group 2, the study group, consisted of all 210 patients who underwent primary surgery f...
320 CitationsSource
Overall outcomes for women with epithelial ovarian cancer (EOC) remain relatively poor, and superior methods of treatment are needed. EOC is a peritoneal surface malignancy that is relatively sensitive to chemotherapy agents, making it a good target for i.p. chemotherapy. Because there is strong laboratory data demonstrating the ability of hyperthermia to increase the efficacy of chemotherapeutic agents, the addition of hyperthermia to i.p. chemotherapy, hyperthermic intraperitoneal chemotherapy...
65 CitationsSource
#1P. HarterH-Index: 21
#2M. Hahmann (University of Marburg)H-Index: 4
Last. A du BoisH-Index: 58
view all 20 authors...
Background Almost all retrospective trials pointed out that a benefit of surgery for recurrent ovarian cancer may be limited to patients in whom a macroscopic complete resection could be achieved. Peritoneal carcinomatosis has been reported to be either a negative predictor for resectability or a negative prognostic factor, or both. The role of peritoneal carcinomatosis in a multicenter trial was investigated.
93 CitationsSource
Cited By11
Newest
#1Xin-Bao Li (Capital Medical University)H-Index: 1
#2Kaiwen Peng (Capital Medical University)
Last. Yan Li (Capital Medical University)H-Index: 16
view all 6 authors...
Background:This study was to assess the risk of venous thromboembolism (VTE) in patients with peritoneal carcinomatosis (PC) and to evaluate the safety and feasibility of physiotherapy program to p...
Source
Purpose Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have become standard of care for many peritoneal malignancies in selected patients. Nevertheless, this aggressive treatment strategy is associated with significant major morbidity. The aim of the present study is to analyze the re-operation rate and clinical outcome following CRS and HIPEC.
Source
#1Qiwen Wu (ZJU: Zhejiang University)
#2Qianqian Wu (ZJU: Zhejiang University)
Last. Xiao Li (ZJU: Zhejiang University)H-Index: 6
view all 7 authors...
AbstractObjective: The role of hyperthermic intraperitoneal chemotherapy (HIPEC) in epithelial ovarian cancer (EOC) is still controversial. Present analysis aims to evaluate the survival benefit of HIPEC in treatment of EOC patients.Methods: Articles related to ‘HIPEC’ and ‘ovarian cancer’ were comprehensively searched in four databases (PubMed, EMBASE, MEDLINE and Cochrane Library) up to 4 February 2018. Eligible studies were identified depending on the selection criteria. The survival outcome ...
Source
Hintergrund Das Prinzip der chirurgischen Therapie peritonealer Metastasen des Ovarialkarzinoms in der Primar- sowie auch in der Rezidivsituation ist die Erreichung einer maximalen Zytoreduktion. Aktuell ist die Addition einer intraperitonealen Chemotherapie nach erfolgter zytoreduktiver Chirurgie kein Standard.
Source
#1Kireeva GsH-Index: 2
#2G. I. GaftonH-Index: 2
Last. Belyaev AmH-Index: 2
view all 9 authors...
Abstract A systematic review of the studies where HIPEC combined with cytoreductive surgery was used in patients with primary advanced ovarian cancer was performed to understand is there a role for this treatment modality not only in recurrent but in primary advanced ovarian cancer. The results are controversial but there is a strong trend for improvement of the long-term outcomes of patients with primary advanced ovarian cancer after HIPEC.
2 CitationsSource
#1Aditi Bhatt (Fortis Healthcare)H-Index: 5
#2Naoual Bakrin (University of Lyon)H-Index: 14
Last. Olivier Glehen (University of Lyon)H-Index: 46
view all 3 authors...
Recurrent ovarian cancer has a propensity for peritoneal spread, and it remains confined to the peritoneal cavity for prolonged periods. An aggressive locoregional therapy comprising of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in addition to systemic chemotherapy has produced promising results in the treatment of this condition for which there is no standard therapy and cure is almost impossible. This treatment has shown an improvement in survival in pati...
Source
#1A. Hotouras (Royal London Hospital)H-Index: 12
#2David DesaiH-Index: 1
Last. Paul H. SugarbakerH-Index: 83
view all 6 authors...
Background Despite advances in surgical oncology, most patients with primary ovarian cancer develop a recurrence that is associated with a poor prognosis. The aim of this review was to establish the impact of Heated IntraPEritoneal Chemotherapy (HIPEC) in the overall survival of patients with recurrent ovarian cancer. Methods A search of PubMed/MEDLINE databases was performed in February 2015 using the terms “recurrent ovarian cancer,” “cytoreductive surgery/cytoreduction,” and “heated/hyperther...
16 CitationsSource
#1Karol PolomH-Index: 14
#2Giandomenico Roviello (University of Brescia)H-Index: 13
Last. Franco RovielloH-Index: 34
view all 9 authors...
Hyperthermic intraperitoneal chemotherapy (HIPEC), a strategy combining maximal cytoreductive surgery and maximal regional chemotherapy, has been applied to treat ovarian cancer resulting in long-term survival rates in selected patients. However, the status of HIPEC in ovarian cancer remains an experimental procedure, given the many variables among the data and trials reviewed, to enable us to derive strong conclusions about its role from this overview. In this review we discuss treatment with H...
6 CitationsSource
#1Ya Ruth Huo (UNSW: University of New South Wales)H-Index: 14
#2A. Richards (UNSW: University of New South Wales)H-Index: 1
Last. David L. Morris (UNSW: University of New South Wales)H-Index: 65
view all 4 authors...
Abstract Purpose Emerging evidence suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) shows a survival benefit over CRS alone for patients with epithelial ovarian carcinoma (EOC). This systematic review and meta-analysis will assess the safety and efficacy of HIPEC with CRS for EOC. Design Searches of five databases from inception to 17/02/15 was performed. Clinical outcomes were synthesised, with full tabulation of results. Results A total of 9 comp...
38 CitationsSource
#1P. Cascales-CamposH-Index: 1
#2J. GilH-Index: 9
Last. P. ParrillaH-Index: 1
view all 4 authors...
Abstract Ovarian cancer is the leading cause of death from gynecological cancer in western countries. The absence of an effective screening program as well as specific symptoms, makes the diagnosis difficult and often made in advanced stages of the disease, in the presence of peritoneal dissemination. The complete cytoreduction of the disease and tumor sensitivity to systemic chemotherapy based on platinums, are the two main prognostic factors. However in patients with complete cytoreduction the...
3 CitationsSource