Objectives To report our preliminary single-center experience with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of peritoneal carcinomatosis (PC) arising from ovarian cancer.
Methods From 2016–2018, 23 patients underwent CRS+HIPEC. CRS was performed with standard peritonectomy procedures and visceral resections directed toward complete elimination of tumors. HIPEC was performed with either cisplatin (50 mg/m²) plus doxorubicin (15 mg/m²), or single-agent cisplatin (100 mg/m²), and allowed to circulate in the abdominopelvic cavity for 90 min at 41.0–42.2°C.
Results Almost all PC cases were primary disease presentations (61.9%) and had high-grade papillary serous histology (90.5%). Cytoreduction completeness (CC-0/1) was achieved in all patients with a median peritoneal cancer index (PCI) of 12±6.3 (range: 3–30). Combination cisplatin+doxorubicin HIPEC chemotherapy was used in 14 patients (66.7%). The median estimated blood loss and hospital stay were 1200±350 mL (range: 800–4500) and 14±5.7 days (range: 8–47), respectively. Major postoperative Clavien-Dindo grade III/IV complications occurred in 3 patients (14.3%), and none developed HIPEC chemotherapy-related toxicities. The median overall survival (OS) and disease-free survival (DFS) after CRS+HIPEC were 18±2.4 and 9.8±3.2 months, respectively. The median follow-up time was 13 months (range: 8–42). In a univariate analysis, patients with CC-0, <12 PCI score and primary PS presentation had statistically higher median 5-year DFS and OS (P<0.05). In a multivariate analysis, CC-0 was shown to be an independent significant prognostic factor for OS (P<0.05).
Conclusions CRS+HIPEC appears to be feasible, safe, and yields survival oncological benefits in patients with PS originating from ovarian cancer.
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