nach oben

Erschienen in:

08.11.2018 | Original Article

Cytoreductive surgery followed by HIPEC repetition for secondary ovarian cancer recurrence

verfasst von: Stefano Cianci, Carlo Ronsini, Giuseppe Vizzielli, Alessandro Tropea, Antonio Biondi, Giovanni Scambia, Anna Fagotti

Erschienen in: Updates in Surgery | Ausgabe 2/2019

Einloggen, um Zugang zu erhalten

Abstract

Secondary and tertiary cytoreductive surgery was associated with improved overall survival in platinum-sensitive recurrent ovarian cancer (ROC). Hyperthermic intraoperative intra-peritoneal chemotherapy (HIPEC) is considered an attractive method in the treatment of ROC to deliver chemotherapy with enhanced effect directly at the tumor site. However, another deserving aspect is the feasibility and the oncologic role of HIPEC repetition. Twelve patients affected by secondary ovarian cancer recurrence previously submitted to cytoreduction followed by HIPEC were enrolled for the present study to receive tertiary cytoreduction followed by HIPEC repetition. The median operative time, including time for HIPEC procedure, was 360 min (range 240–540). Average EBL was 325 ml (from 100 to 500 ml). The median hospital stay was of 5 days, from 4 to 10. Low-grade post operatory complications occurred in 2 patients (16.6%) and high-grade complication in 1 case (8.3%). Our study report encouraging data about safety of HIPEC repetition in ovarian cancer treatment.

Laganà AS, Vitale SG, Trovato MA et al (2016) Full-thickness excision versus shaving by laparoscopy for intestinal deep infiltrating endometriosis: rationale and potential treatment options. Biomed Res Int 2016:3617179. https://doi.org/10.1155/2016/3617179 CrossRefPubMedPubMedCentral

Caruso S, Cianci S, Vitale SG et al (2017) Effects of ultralow topical estriol dose on vaginal health and quality of life in postmenopausal women who underwent surgical treatment for pelvic organ prolapse. Menopause 24:900–907. https://doi.org/10.1097/GME.0000000000000851 CrossRefPubMed

Caruso S, Rugolo S, Bandiera S et al (2007) Clitoral blood flow changes after surgery for stress urinary incontinence: pilot study on TVT versus TOT procedures. Urology 70:554–557. https://doi.org/10.1016/j.urology.2007.04.045 CrossRefPubMed

Lagana AS, Vitale SG, De Dominici R et al (2016) Fertility outcome after laparoscopic salpingostomy or salpingectomy for tubal ectopic pregnancy a 12-years retrospective cohort study. Ann Ital Chir 87:461–465PubMed

Vitale SG, Laganà AS, Gulino FA et al (2016) Prosthetic surgery versus native tissue repair of cystocele: literature review. Updates Surg 68:325–329. https://doi.org/10.1007/s13304-015-0343-y CrossRefPubMed

Vitale SG, Sapia F, Rapisarda AMC et al (2017) Hysteroscopic morcellation of submucous myomas: a systematic review. Biomed Res Int 2017:6848250. https://doi.org/10.1155/2017/6848250 CrossRefPubMedPubMedCentral

Sturlese E, Triolo O, Grasso R et al (2017) Thromboembolism prophylaxis in laparoscopic surgery for gynecologic benign diseases. Results of a single center experience in 922 procedures. Ann Ital Chir 88:342–347PubMed

Di Sardo Spiezio A, Vieira MDC, Laganà AS et al (2017) Combined systemic and hysteroscopic intra-amniotic injection of methotrexate associated with hysteroscopic resection for cervical pregnancy: a cutting-edge approach for an uncommon condition. Eurasian J Med 49:66–68. https://doi.org/10.5152/eurasianjmed.2017.16215 CrossRef

Di Sardo Spiezio A, Di Guardo F, Santangelo F, Cianci S, Giampaolino P (2017) Commentary on “Assessment of risk factors of intrauterine adhesions in patients with induced abortion and the curative effect of hysteroscopic surgery”. J Investig Surg 18:1–3. https://doi.org/10.1080/08941939.2017.1400133 CrossRef

10.

Bellia A, Vitale SG, Laganà AS, Cannone F, Houvenaeghel G, Rua S, Ladaique A, Jauffret C, Ettore G, Lambaudie E (2016) Feasibility and surgical outcomes of conventional and robot-assisted laparoscopy for early-stage ovarian cancer: a retrospective, multicenter analysis. Arch Gynecol Obstet 294(3):615–622CrossRefPubMed

11.

Cignini P, Vitale SG, Laganà AS, Biondi A, La Rosa VL, Cutillo G (2017) Preoperative work-up for definition of lymph node risk involvement in early stage endometrial cancer: 5-year follow-up. Updates Surg 69(1):75–82CrossRefPubMed

12.

Rossetti D, Vitale SG, Tropea A, Biondi A, Laganà AS (2017) New procedures for the identification of sentinel lymph node: shaping the horizon of future management in early stage uterine cervical cancer. Updates Surg 69(3):383–388CrossRefPubMed

13.

Tozzi R, Giannice R, Cianci S et al (2015) Neo-adjuvant chemotherapy does not increase the rate of complete resection and does not significantly reduce the morbidity of Visceral–Peritoneal Debulking (VPD) in patients with stage IIIC–IV ovarian cancer. Gynecol Oncol 138:252–258. https://doi.org/10.1016/j.ygyno.2015.05.010 CrossRefPubMed

14.

Gueli Alletti S, Rossitto C, Cianci S, Scambia G (2016) Telelap ALF-X total hysterectomy for early stage endometrial cancer: new frontier of robotic gynecological surgery. Gynecol Oncol 140:575–576. https://doi.org/10.1016/j.ygyno.2016.01.018 CrossRefPubMed

15.

Gueli Alletti S, Rossitto C, Cianci S et al (2016) Telelap ALF-X vs standard laparoscopy for the treatment of early-stage endometrial cancer: a single-institution retrospective cohort study. J Minim Invasive Gynecol 23:378–383. https://doi.org/10.1016/j.jmig.2015.11.006 CrossRefPubMed

16.

Gueli Alletti S, Rossitto C, Perrone E et al (2017) Needleoscopic conservative staging of borderline ovarian tumor. J Minim Invasive Gynecol 24:529–530. https://doi.org/10.1016/j.jmig.2016.10.009 CrossRefPubMed

17.

Chiofalo B, Palmara V, Laganà AS et al (2017) Fertility sparing strategies in patients affected by placental site trophoblastic tumor. Curr Treat Options Oncol 18:58. https://doi.org/10.1007/s11864-017-0502-0 CrossRefPubMed

18.

Vitale SG, La Rosa VL, Rapisarda AMC, Lagana AS (2017) The importance of fertility preservation counseling in patients with gynecologic cancer. J Reprod Infertil 18:261–263PubMedPubMedCentral

19.

Vitale SG, La Rosa VL, Rapisarda AMC et al (2018) Fertility preservation in women with gynaecologic cancer: the impact on quality of life and psychological well-being. Hum Fertil (Camb) 21:35–38. https://doi.org/10.1080/14647273.2017.1339365 CrossRef

20.

Laganà AS, La Rosa VL, Rapisarda AMC et al (2017) Psychological impact of fertility preservation techniques in women with gynaecological cancer. Ecancermedicalscience 11:ed62. https://doi.org/10.3332/ecancer.2017.ed62 CrossRefPubMedPubMedCentral

21.

Gueli Alletti S, Vizzielli G, Lafuenti L, Costantini B, Fagotti A, Fedele C, Cianci S, Perrone E, Gallotta V, Rossitto C, Scambia G (2018) Single-institution propensity-matched study to evaluate the psychological effect of minimally invasive interval debulking surgery versus standard laparotomic treatment: from body to mind and back. J Minim Invasive Gynecol 25(5):816–822CrossRefPubMed

22.

Laganà AS, La Rosa VL, Rapisarda AMC et al (2017) Anxiety and depression in patients with endometriosis: impact and management challenges. Int J Womens Health 9:323–330. https://doi.org/10.2147/IJWH.S119729 CrossRefPubMedPubMedCentral

23.

Vitale SG, La Rosa VL, Rapisarda AMC, Laganà AS (2017) Impact of endometriosis on quality of life and psychological well-being. J Psychosom Obstet Gynaecol 38:317–319. https://doi.org/10.1080/0167482X.2016.1244185 CrossRefPubMed

24.

Rossitto C, Gueli Alletti S, Rotolo S et al (2016) Total laparoscopic hysterectomy using a percutaneous surgical system: a pilot study towards scarless surgery. Eur J Obstet Gynecol Reprod Biol 203:132–135. https://doi.org/10.1016/j.ejogrb.2016.05.007 CrossRefPubMed

25.

Gueli Alletti S, Rossitto C, Cianci S et al (2018) The Senhance^TM surgical robotic system (“Senhance”) for total hysterectomy in obese patients: a pilot study. J Robot Surg 12:229–234. https://doi.org/10.1007/s11701-017-0718-9 CrossRefPubMed

26.

Gueli Alletti S, Perrone E, Cianci S et al (2018) 3 mm Senhance robotic hysterectomy: a step towards future perspectives. J Robot Surg. https://doi.org/10.1007/s11701-018-0778-5 CrossRefPubMed

27.

Rossitto C, Cianci S, Gueli Alletti S et al (2017) Laparoscopic, minilaparoscopic, single-port and percutaneous hysterectomy: comparison of perioperative outcomes of minimally invasive approaches in gynecologic surgery. Eur J Obstet Gynecol Reprod Biol 216:125–129. https://doi.org/10.1016/j.ejogrb.2017.07.026 CrossRefPubMed

28.

Cosentino F, Vizzielli G, Turco LC et al (2018) Near-infrared imaging with indocyanine green for detection of endometriosis lesions (Gre-Endo Trial): a pilot study. J Minim Invasive Gynecol. https://doi.org/10.1016/j.jmig.2018.02.023 CrossRefPubMed

29.

Rapisarda AMC, Cianci A, Caruso S et al (2018) Benign multicystic mesothelioma and peritoneal inclusion cysts: are they the same clinical and histopathological entities? A systematic review to find an evidence-based management. Arch Gynecol Obstet 297:1353–1375. https://doi.org/10.1007/s00404-018-4728-2 CrossRefPubMed

30.

Gallotta V, Conte C, Giudice MT et al (2017) Secondary laparoscopic cytoreduction in recurrent ovarian cancer: a large, single-institution experience. J Minim Invasive Gynecol 25:644–650. https://doi.org/10.1016/j.jmig.2017.10.024 CrossRefPubMed

31.

Fagotti A, Costantini B, Gallotta V et al (2015) Minimally invasive secondary cytoreduction plus HIPEC versus open surgery plus HIPEC in isolated relapse from ovarian cancer: a retrospective cohort study on perioperative outcomes. J Minim Invasive Gynecol 22:428–432. https://doi.org/10.1016/j.jmig.2014.11.008 CrossRefPubMed

32.

Fanfani F, Fagotti A, Ercoli A et al (2015) Is there a role for tertiary (TCR) and quaternary (QCR) cytoreduction in recurrent ovarian cancer? Anticancer Res 35:6951–6955PubMed

33.

Bristow RE, Puri I, Chi DS (2009) Cytoreductive surgery for recurrent ovarian cancer: a meta-analysis. Gynecol Oncol 112:265–274. https://doi.org/10.1016/j.ygyno.2008.08.033 CrossRefPubMed

34.

Petrillo M, De Iaco P, Cianci S et al (2016) Long-term survival for platinum-sensitive recurrent ovarian cancer patients treated with secondary cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC). Ann Surg Oncol 23:1660–1665. https://doi.org/10.1245/s10434-015-5050-x CrossRefPubMed

35.

Cockcroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16:31–41. https://doi.org/10.1159/000180580 CrossRefPubMed

36.

Sugarbaker PH, Jablonski KA (1995) Prognostic features of 51 colorectal and 130 appendiceal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery and intraperitoneal chemotherapy. Ann Surg 221:124–132CrossRefPubMedPubMedCentral

37.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

38.

Issels RD (2008) Hyperthermia adds to chemotherapy. Eur J Cancer 44:2546–2554. https://doi.org/10.1016/j.ejca.2008.07.038 CrossRefPubMed

39.

Fagotti A, Costantini B, Vizzielli G et al (2011) HIPEC in recurrent ovarian cancer patients: morbidity-related treatment and long-term analysis of clinical outcome. Gynecol Oncol 122:221–225. https://doi.org/10.1016/j.ygyno.2011.04.008 CrossRefPubMed

40.

Cianci S, Vizzielli G, Fagotti A et al (2018) A novel HIPEC technique using hybrid CO₂ recirculation system: intra-abdominal diffusion test in a porcine model. Updates Surg. https://doi.org/10.1007/s13304-018-0557-x CrossRefPubMed

41.

Cianci S, Abatini C, Fagotti A et al (2018) Hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies using new hybrid CO₂ system: preliminary experience in referral center. Updates Surg. https://doi.org/10.1007/s13304-018-0578-5 CrossRefPubMed

42.

Paris I, Cianci S, Vizzielli G et al (2018) Upfront HIPEC and bevacizumab-containing adjuvant chemotherapy in advanced epithelial ovarian cancer. Int J Hyperth. https://doi.org/10.1080/02656736.2018.1503346 CrossRef

43.

Falcone F, Scambia G, Benedetti Panici P et al (2017) Tertiary cytoreductive surgery in recurrent epithelial ovarian cancer: a multicentre MITO retrospective study. Gynecol Oncol 147:66–72. https://doi.org/10.1016/j.ygyno.2017.07.008 CrossRefPubMed

44.

Vitale SG, Caruso S, Rapisarda AMC et al (2018) Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study. Prz Menopauzalny 17:32–38. https://doi.org/10.5114/pm.2018.73791 CrossRefPubMedPubMedCentral

45.

Caruso S, Cianci S, Fava V et al (2018) Vaginal health of postmenopausal women on nutraceutical containing equol. Menopause 25:430–435. https://doi.org/10.1097/GME.0000000000001061 CrossRefPubMed

46.

Caruso S, Cianci S, Cariola M et al (2017) Improvement of low sexual desire due to antiandrogenic combined oral contraceptives after switching to an oral contraceptive containing 17β-Estradiol. J Womens Health (Larchmt) 26:728–734. https://doi.org/10.1089/jwh.2016.5801 CrossRef

47.

Caruso S, Cianci S, Cariola M et al (2017) Effects of nutraceuticals on quality of life and sexual function of perimenopausal women. J Endocrinol Investig 40:27–32. https://doi.org/10.1007/s40618-016-0500-2 CrossRef

48.

Caruso S, Rapisarda AM, Cianci S (2016) Sexuality in menopausal women. Curr Opin Psychiatry 29:323–330. https://doi.org/10.1097/YCO.0000000000000280 CrossRefPubMed

49.

Caruso S, Cianci S, Amore FF et al (2016) Quality of life and sexual function of naturally postmenopausal women on an ultralow-concentration estriol vaginal gel. Menopause 23:47–54. https://doi.org/10.1097/GME.0000000000000485 CrossRefPubMed

50.

Caruso S, Agnello C, Malandrino C et al (2014) Do hormones influence women’s sex? Sexual activity over the menstrual cycle. J Sex Med 11:211–221. https://doi.org/10.1111/jsm.12348 CrossRefPubMed

Titel: Cytoreductive surgery followed by HIPEC repetition for secondary ovarian cancer recurrence
verfasst von: Stefano Cianci
Carlo Ronsini
Giuseppe Vizzielli
Alessandro Tropea
Antonio Biondi
Giovanni Scambia
Anna Fagotti
Publikationsdatum: 08.11.2018
Verlag: Springer International Publishing
Erschienen in: Updates in Surgery / Ausgabe 2/2019
Print ISSN: 2038-131X
Elektronische ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-018-0600-y

Neu im Fachgebiet Chirurgie

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2019

Never put equipoise in appendix! Final results of ASAA (antibiotics vs. surgery for uncomplicated acute appendicitis in adults) randomized controlled trial

Laparoscopic resection of splenic flexure colon cancers: a retrospective multi-center study with 117 cases

Intraoperative ultrasonography in patients undergoing surgery for Crohn’s disease. Prospective evaluation of an innovative approach to optimize staging and treatment planning

Burnout and psychological distress between surgical and non-surgical residents

A stepwise learning curve to define the standard for technical improvement in laparoscopic liver resections: complexity-based analysis in 1032 procedures

The impact of experience on short- and long-term outcomes on gastric ESD: a western series

Update Chirurgie