Cytoreductive surgery and modified heated intraoperative intraperitoneal chemotherapy (HIPEC) for advanced and recurrent ovarian cancer – 12-year single center experience

Pavlov, M.J.; Kovacevic, P.A.; Ceranic, M.S.; Stamenkovic, A.B.; Ivanovic, A.M.; Kecmanovic, D.M.

doi:10.1016/j.ejso.2009.03.004

« Previous Next »European Journal of Surgical Oncology
Volume 35, Issue 11 , Pages 1186-1191, November 2009

Cytoreductive surgery and modified heated intraoperative intraperitoneal chemotherapy (HIPEC) for advanced and recurrent ovarian cancer – 12-year single center experience

M.J. Pavlov
- Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia
P.A. Kovacevic
- Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia
M.S. Ceranic
- Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia
A.B. Stamenkovic
- Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia
A.M. Ivanovic
- Department for Radiology, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, Belgrade, Serbia
D.M. Kecmanovic
- Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia
- Corresponding author. Tel.: +381 11 361 5 654; fax: +381 11 361 5 655.

Accepted 5 March 2009.

Abstract

Background

The present study reviews our 12-year results with cytoreductive surgery and HIPEC in patients with advanced primary and recurrent ovarian cancer.

Methods

During the period from January 1995 to December 2007, 56 patients (31 with primary and 25 with recurrent epithelial ovarian cancer) underwent cytoreductive surgery and HIPEC (Doxorubicin intra-operatively, and cisplatin next 1–5 postoperative days) at our department.

Results

52 (92.8%) patients had no gross residual disease after the complete surgical procedure (Sugarbaker completeness of cytoreduction CC, score 0–1), and 4 patients had macroscopic residual disease (CC-2 or CC-3) Average PCI (peritoneal cancer index) was 13.4 (4–28). Mean follow-up was 56 months (range, 1–135). The median operation time was 279min (range 190±500min). Median total blood loss was 850mL (range 250±1550mL). The median survival time was 34.1 months for primary, 40.1 for recurrent ovarian cancer without statistically significance difference (p>0.05) and median disease-free survival was 26.2 months. The PCI was equal or less than 12 in 31 patients and their median survival time was statistically significant longer than median survival time of months for the 25 patients with PCI greater then 12 (p<0.01). Morbidity and mortality rate were 17.8% (10/56) and 1.8% (1/56).

Conclusion

This series indicates that in the majority of patients with primary and recurrent advanced ovarian cancer, cytoreductive surgery combined with HIPEC can lead to a substantial increase in subsequent rates of disease-free and overall survival.

Keywords: Primary ovarian cancer, Cytoreduction, Recurrent ovarian, HIPEC