Hyperthermic Intraperitoneal Chemotherapy after Secondary Cytoreduction in Epithelial Ovarian Cancer: A Single-center Comparative Analysis

• Published in: Annals of surgical oncology 2016-04, Vol.23 (4), p.1294-1301
• Main Authors: Baiocchi, Glauco, Ferreira, Fabio Oliveira, Mantoan, Henrique, da Costa, Alexandre Andre Balieiro Anastacio, Faloppa, Carlos Chaves, Kumagai, Lillian Yuri, de Mello, Celso Abdon Lopes, Takahashi, Renata Mayumi, Nakagawa, Wilson Toshihiko, Aguiar, Samuel, Lopes, Ademar
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Clear Cell - pathology; Adenocarcinoma, Clear Cell - surgery; Adenocarcinoma, Clear Cell - therapy; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - surgery; Adenocarcinoma, Mucinous - therapy; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Combined Modality Therapy; Cystadenocarcinoma, Serous - pathology; Cystadenocarcinoma, Serous - surgery; Cystadenocarcinoma, Serous - therapy; Cytoreduction Surgical Procedures - methods; Endometrial Neoplasms - pathology; Endometrial Neoplasms - surgery; Endometrial Neoplasms - therapy; Female; Follow-Up Studies; Gynecologic Oncology; Humans; Hyperthermia, Induced - methods; Injections, Intraperitoneal; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - surgery; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Oncology; Ovarian cancer; Ovarian Neoplasms - pathology; Ovarian Neoplasms - surgery; Ovarian Neoplasms - therapy; Prognosis; Surgery; Surgical Oncology; Survival Rate
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-015-4991-4

Background Although the standard of care after recurrence of epithelial ovarian cancer (EOC) is chemotherapy, increasing data suggest that combining cytoreductive surgery with intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising option for patients with recurrent EOC. Our aim was to determine the prognostic value of the addition of HIPEC to secondary cytoreductive surgery (SCR) in recurrent EOC. Methods We analyzed a series of 79 patients with platinum-sensitive recurrent EOC who were treated from May 2000 to January 2014. Fifty patients who underwent SCR were compared to 29 who had SCR in combination with HIPEC. Results The SCR group had a higher median age (58.4 years) compared to the SCR + HIPEC group (51.6 years) ( p  = 0.006). The median hospital stay length was longer for SCR + HIPEC versus SCR patients (11 and 8 days, respectively; p  = 0.009). More subjects experienced National Cancer Institute grade III–IV morbidity in the SCR + HIPEC group (34.5 %) compared to the SCR group (10.6 %) ( p  = 0.015). Conversely, there were no deaths in the SCR + HIPEC group and 2 (4.0 %) deaths the SCR group. The median disease-free survival did not differ between SCR and SCR + HIPEC patients (18.6 and 15.8 months, respectively; p  = 0.82); nor did median overall survival (59.3 and 58.3 months, respectively; p  = 0.95). The presence of carcinomatosis was the only variable that remained linked to a higher risk of recurrence and death in the multivariate analysis. Conclusions Our data suggest that the addition of HIPEC to cytoreduction in patients with recurrent platinum-sensitive EOC does not improve survival.