Hyperthermic Intraperitoneal Chemotherapy for Treatment of Ovarian and Primary Peritoneal Malignancies: Single Institutional Experience

Abstract

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.