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292 Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced ovarian, fallopian tube or primary peritoneal cancer: our experience in 108 patients
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  1. ME Capilna1,
  2. B Moldovan2,
  3. C Rad2,
  4. AA Moldovan3,
  5. AL Cozlea1,
  6. A Fandi1,
  7. M Gheorghe1 and
  8. SL Kiss1
  1. 1University of Medicine- Pharmacy- Science and Technology, First Obstetrics and Gynecology Clinic, Targu Mures, Romania
  2. 2St. Constantin Hospital, Department of General Surgery, Brasov, Romania
  3. 3St. Constantin Hospital, Department of Epidemiology and Infectious Diseases, Brasov, Romania

Abstract

Objectives Current evidence suggests that complete cytoreductive surgery (CRS) and hypertermic intraperitoneal chemotherapy (HIPEC) is a feasible option for patients with advanced ovarian, fallopian tube or primary peritoneal cancer with potential benefits that may exceed the survival outcomes of current - surgical debulking and intravenous platinum- and taxane-based chemotherapy.

Methods It is a retrospective study including 108 patients with primary or recurrent peritoneal carcinomatosis, operated between 2013 and 2019, with a mean age of 53.7 years.

Results Seventy eight patients (72%) had primary debulking and 30 (27%) had surgery for a recurrent disease. The peritoneal cancer index (PCI) was below 15 in 50 patients (46%) and above 15 in 58 (53%), respectively. Together with total peritonectomy, large bowel resection was performed in 55 patients (50.9%), small bowel resection in 13 (12%), and splenectomy in 38 (35%). Other upper abdominal procedures included liver resection (13%), colecistectomy (35%), gastric resection (1.8%), diaphragm resection (12%), etc. Microscopically complete cytoreduction (CC0) was achieved for 68 patients (63%), macroscopic cytoreduction (CC1) for 35 (32%), and gross tumour debulking (CC2) for 5 (4%). Only 3 patients (2.7%) have been reoperated. For HIPEC, Cisplatin and respectively, Doxorubicin were both used for 30 patients (27%), Other regimen included Cisplatin plus Doxorubicin (41%), Cisplatin plus Mitomicine or Mitomicine alone. Nine patients (8%) died of disease, 15 (13%) are alive with reccurent disease, and 84 (77%) are disease-free, but the follow-up is short.

Conclusions HIPEC after extensive CRS for advanced gynecological cancer with peritoneal carcinomatosis is a feasible option with promising results.

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