Hyperthermic Intraperitoneal Chemotherapy for Treatment of Ovarian and Primary Peritoneal Malignancies: Single Institutional Experience (Pages 53-59)
Vaagn Andikyan1, Parissa Tabrizian2, Sara Farag1, Jessica Fields1, Valentin Kolev1, Jamal Rahaman1, David Fishman1, Umut Sarpel2, Konstantin Zakashansky1 and Daniel Labow2
1Department of Obstetrics, Gynecology and Reproductive Science, Division of Gynecologic Oncology, Icahn School of Medicine at Mount Sinai, NY 10029, USA; 2Department of Surgery, Division of Surgical Oncology, Icahn School of Medicine at Mount Sinai, NY 10029, USA
Objective: To report our institutional experience on hyperthermic intraperitoneal chemotherapy (HIPEC) at the time of cytoreductive surgery (CRS) for ovarian, fallopian tube and primary peritoneal cancer.
Methods: We reviewed charts of patients who underwent CRS and HIPEC. Optimal cytoreduction was defined as residual disease < 1cm. HIPEC was administered using closed technique. The postoperative complications were graded using the Clavien-Dindo classification. Grade III and IV complications were considered as major. Survival was estimated using the Kaplan-Meier method.
Results: During the study period, we identified 262 patients who underwent HIPEC and CRS. Fifteen of those patients (6%) were diagnosed with gynecologic tumors. Five patients (33%) had primary CRS and HIPEC for primary peritoneal carcinoma and ten patients (66%) had CRS and HIPEC for recurrent ovarian tumors. The median OR time was 327 min. Optimal cytoreduction was achieved in all patients (100%) and 7 patients (47%) had no gross residual disease. Major postoperative complications were reported in five patients (33%). The median follow up was 34 months. The median progression free survival (PFS) was 7 months (95% confidence interval (CI), 1-15 months) for recurrent disease. For the primary disease the median PFS was 26 months (95% CI: 7-26 months) comparable with IP arm in GOG-172.
Conclusion: Combination of CRS and HIPEC is a feasible therapeutic modality for patients with ovarian, fallopian tube and primary peritoneal malignancies. Addition of HIPEC to CRS does not seem to increase the rate of grade III and IV postoperative complications and may be associated with survival benefit.
Keywords: HIPEC, ovarian cancer, debulking, outcomes, survival.