Introduction/Background Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer patients with peritoneal metastasis remains controversial concerning patient selection, safety, efficacy and costs. A randomized phase 2 trial failed to show survival superiority for interval cytoreductive surgery (ICRS) with HIPEC compared to surgery alone. HIPEC group had more anemia and creatinine elevation. Recently, a phase 3 trial showed longer recurrence-free and overall survival for HIPEC group, without increasing toxicity. We aimed to evaluate safety and efficacy of ICRS with HIPEC.
Methodology Retrospective cohort of patients submitted to ICRS and HIPEC with cisplatin 50 mg/m2, from 2013 to 2018. Data were analyzed using descriptive statistics and survival was estimated by Kaplan-Meier method.
Results Thirty patients were included, median age was 60 years (IQR, 15) and all had ECOG <2. Stage was IIIC (FIGO, 2014) in 56.7% (17/30). Median peritoneal cancer index was 11 (IQR, 15). After surgery, 66.7% (20/30) were admitted to the intensive-care unit (ICU), and 33.3% (10/30) to the high-dependency unit (HDU). Mean APACHE II and SAPS II score was 9.7 and 25.5, respectively. Ten percent (3/30) needed invasive mechanical ventilation, despite 23.3% (7/30) developed respiratory failure. None (0/30) had hemodynamic instability or renal failure. Anemia occurred in 73.3% (22/30); mean lower hemoglobin level was 10.5 (±1.3) g/dL. Median length of stay in ICU/HDU was 2 days (IQR, 1) and in the hospital was 11 days (IQR, 5). One patient needed reoperation due to gastrointestinal leakage and peritonitis; and one had right femoral nerve neuropraxia. There was no readmission to ICU/HDU or in-hospital mortality. After a median follow-up of 14 months, 40% (12/30) progressed and 33.3% (10/30) died. Median PFS was 8 months (95% CI 4.7–11.3) and OS was 10 months (95% CI 0.7–19.3).
Conclusion In our cohort HIPEC was a safe technique. Long-term outcomes suggest the benefit of this procedure in the management of well-selected patients.
Disclosure Nothing to disclose.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.