Objectives Studies have highlighted the benefits of combining cytoreductive surgery with HIPEC to improve survival in primary and recurrent EOC. However, data regarding the use of carboplatin-based HIPEC is limited, but seems promising in a few studies. It has lower rates of adverse effects, especially nephrotoxicity, with systemic use compared to cisplatin. In efforts to minimize morbidity, carboplatin is an important alternative to consider compared to standard HIPEC regimen.
Methods We retrospectively evaluated patients with advanced EOC who underwent CRS combined with carboplatin-based HIPEC at our center since 2013. Data collected included patients’ demographics, surgical morbidity and outcomes.
Results We identified 54 patients with a median age of 60 years. There were 48 patients with primary disease and 6 with recurrent EOC. The median peritoneal cancer index was 13 and complete cytoreduction was achieved in 49 patients (91%). Median hospital stay was 14 days and there were 6 admissions to ICU (11%) and 7 readmissions (13%). Severe adverse events occurred in 12 patients (22%) and there was no perioperative or postoperative death. Recurrence was seen in 37 patients (73%) with a median disease-free survival of 13.0 months and overall survival of 26.0 months. Cox multivariate analyses showed that completeness of cytoreduction had a significant impact on DFS. Age, PCI, occurrence of severe complications, and bowel resection did not significantly alter DFS and OS in our cohort.
Conclusions Extensive CRS combined with carboplatin-based HIPEC for advanced EOC presents acceptable morbidity and outcomes in our cohort. Larger studies are required to determine long-term oncological outcomes.
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