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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Persistent and Recurrent Advanced Ovarian Carcinoma: A Multicenter, Prospective Study of 246 Patients

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Epithelial ovarian carcinoma is the main cause of death from gynaecological cancers in the western world. The initial response rate to the frontline therapy is high. However, the prognosis of persistent and recurrent disease remains poor. During the two past decades, a new therapeutic approach to peritoneal carcinomatosis has been developed, combining maximal cytoreductive effort with hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods

A retrospective, multicentric study of 246 patients with recurrent or persistent ovarian cancer, treated by cytoreductive surgery and HIPEC in two French centers between 1991 and 2008, was performed.

Results

An optimal cytoreductive surgery was possible in 92.2 % of patients. Mortality and morbidity rates were 0.37 % and 11.6 %, respectively. The overall median survival was 48.9 months. There was no significant difference in overall survival in patients with persistent or recurrent disease. In multivariate analysis, performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (peritoneal cancer index >10).

Conclusions

Salvage therapy combining optimal cytoreductive surgery and HIPEC is feasible and may achieve long-term survival in highly selected patients with recurrent ovarian carcinoma, including those with platinum resistant disease, with acceptable morbidity.

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Authors and Affiliations

  1. Department of Oncologic Surgery, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    N. Bakrin MD, E. Cotte MD, F. N. Gilly MD, PhD & O. Glehen MD, PhD

  2. French Trophoblastic Disease Reference Center, Université Lyon 1, Lyon, France

    F. Golfier MD, PhD

  3. Department of Medical Oncology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France

    G. Freyer MD, PhD

  4. Department of Obstetrics, Gynecology and Women’s Health, St Louis University School of Medicine, St. Louis, MO, USA

    W. Helm MD, PhD

  5. Department of Surgery, Centre Hospitalo-Universitaire de Nice, Nice, France

    J. M. Bereder MD

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  1. N. Bakrin MD
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  4. F. N. Gilly MD, PhD
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Correspondence to N. Bakrin MD.

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Bakrin, N., Cotte, E., Golfier, F. et al. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Persistent and Recurrent Advanced Ovarian Carcinoma: A Multicenter, Prospective Study of 246 Patients. Ann Surg Oncol 19, 4052–4058 (2012). https://doi.org/10.1245/s10434-012-2510-4

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  • DOI: https://doi.org/10.1245/s10434-012-2510-4

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