Article Text
Abstract
Introduction Surgical debulking of pleural and lung parenchymal disease in ovarian malignancy alongwith abdominal disease can be done with a multispeciality approach.The addition of hyperthermic intrathoracic chemotherapy (HITHOC) to the surgical debulking and hyperthermic intra-peritoneal chemotherapy (HIPEC) known as hyperthermic intraoperative thoracoabdominal chemotherapy (HITAC) is a novel procedure.The primary objective of this study was to assess the feasibility of the addition of HITHOC to the HIPEC procedure during interval debulking surgery(IDS) in cases of stage IV epithelial ovarian carcinoma.
Methods It was a prospective observational study. Patients with FIGO stage IV (2017) with ECOG performance score 0 to 1 who had undergone 3-4 cycles of NACT were selected.Patients were recruited over one year. Intraoperative - postoperative morbidity, adverse events and mortality were followed up till recurrence or mortality whichever occured later.
Results A total of 8 patients were selected over a period of one year (August 2022-July 2023). Complete gross resection of disease was achieved in all patients. Median blood loss was 600ml. Three patients were transfused 2 units blood and four patients were transfused one unit blood each. No grade 3 or more complications(CTCAE) were noted. One patient had recurrence at 5.5 months. Disease progressed on chemotherapy and patient succumbed to disease. The longest follow up was 20 months.
Conclusion/Implications After an optimal debulking is done in stage IV ovarian carcinoma in the abdominopelvic cavity, VATS followed by debulking of chest disease and addition of HITHOC to the hyperthermic intraperitoneal chemotherapy (HIPEC )procedure is feasible without any additional morbidity.