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Intraperitoneal Chemotherapy by Ultrasound-Guided Direct Puncture in Recurrent Ovarian Cancer: Feasibility, Compliance, and Complications
  1. Pierluigi Benedetti-Panici, MD*,
  2. Giorgia Perniola, PhD*,
  3. Claudia Marchetti, MD*,
  4. Milena Pernice, MD*,
  5. Cristina Donfrancesco, MD*,
  6. Violante Di Donato, MD*,
  7. Federica Tomao, MD*,
  8. Innocenza Palaia, PhD*,
  9. Marialida Graziano, MD*,
  10. Stefano Basile, PhD and
  11. Filippo Bellati, PhD*
  1. *Department of Gynaecology and Obstetrics, “Sapienza” University of Rome, Rome; and
  2. II Department of Obstetrics and Gynecology “S. Chiara” University Hospital of Pisa, Pisa, Italy.
  1. Address correspondence and reprint requests to Giorgia Perniola, PhD, Department Gynecology and Obstetrics, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy. E-mail: pergio{at}


Objective This prospective pilot study investigated the feasibility, complications, and compliance of the administration of intraperitoneal (IP) chemotherapy by direct puncture under ultrasonographic guidance performed on consecutive patients with recurrent ovarian cancer (ROC).

Methods Patients were evaluated to undergo secondary cytoreduction and/or to receive IP chemotherapy. Patients received standard intravenous therapy for ROC plus IP administration by direct puncture needle, under ultrasonographic guidance.

Results From January 2008 to January 2011, 38 patients were enrolled. A total of 402 IP procedures were performed, with a mean of 10.5 procedures per patient. The feasibility rate was 97.4%. In 237 cases (98.8%) of subgroup 1 (abdominal wall thickness ⩽6 cm), the procedure was performed after 1 attempt, meanwhile in 6% of cases of subgroup 2 (abdominal wall thickness >6 cm), more than 1 attempt was necessary (P < 0.01). The mean procedure time was 10 minutes (range, 5–30 minutes). We recorded a total of 2.25% mild intraprocedure complications. No significant difference was identified for the complication rate according to the abdominal wall thickness or according to the number of previous laparotomies. A total of 5 procedures (1.2%) were not performed as a result of patients’ noncompliance. The mean pain score according to the visual analog pain scale was moderate at the first evaluation (after 3 minutes) and mild at the final evaluation (after 10 minutes).

Conclusions The administration of IP chemotherapy with a direct puncture, under ultrasound guidance, for patients with ROC, is a safe and feasible method, with a high acceptance from patients.

  • Intraperitoneal chemotherapy
  • Recurrent ovarian cancer
  • Ultrasound-guided direct puncture

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