Introduction/Background Extensive cytoreduction in combination with Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) is emerging as a safe and effective method for the treatment of advanced ovarian cancer. The purpose of this study was the identification of prognostic variables for survival and recurrence in a group of patients with recurrent ovarian cancer undergoing secondary cytoreductive surgery with HIPEC.
Methodology From 2005–2017, 181 patients with recurrent ovarian cancer underwent treatment with cytoreductive surgery combined with HIPEC. Clinical and pathological variables were correlated to survival and recurrence. Hospital mortality and morbidity were recorded. All patients were treated by a single leading surgeon using a standard surgical technique and HIPEC protocol.
Results The patients‘ mean age was 56.6±10.4 years. The mean Peritoneal Cancer Index (PCI) was 14.3. Complete (CC-0) or near complete (CC-1) cytoreduction was possible in 84.5% of the patients. The hospital mortality and morbidity rate were 1.7% and 30.4% respectively. The overall survival for 1, 3, 5, and 10 years was 73%, 48%, 36%, and 32% respectively. The statistically significant favorable prognostic variables of survival were a) limited extent of peritoneal carcinomatosis, b) administration of adjuvant systemic chemotherapy and c) high histological differentiation. Recurrence was recorded in 55.4% of the patients. The statistically significant favorable prognostic variables of recurrence were
a. limited extent of peritoneal carcinomatosis,
b. limited extent of primary surgical procedures and
c. high histological differentiation.
Conclusion Complete or near complete cytoreduction is feasible in the vast majority of patients with recurrent ovarian cancer. In our cohort, secondary cytoreductive surgery with HIPEC significantly improved the outcome of those patients. The limited extent of peritoneal carcinomatosis and the high histological degree of differentiation were the most important favorable variables for long-term survival and risk of recurrence.
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