Effect of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy on epithelial ovarian, fallopian tube, and peritoneal cancer: An institutional review of outcomes and its clinical implications
- Author:
Romelyn April P. Imperio‑Onglao
1
;
Jericho Thaddeus P. Luna
1
Author Information
- Publication Type:Journal Article
- Keywords: Fallopian cancer; Peritoneal cancer
- MeSH: Cytoreduction Surgical Procedures; Hyperthermic Intraperitoneal Chemotherapy; Ovarian Neoplasms
- From: Philippine Journal of Obstetrics and Gynecology 2024;48(1):10-21
- CountryPhilippines
- Language:English
-
Abstract:
Background:Ovarian, fallopian tube, and peritoneal cancer patients with advanced-stage diagnosis or recurrences spread to the peritoneal surface of the abdomen. Hyperthermic intraperitoneal chemotherapy (HIPEC) can penetrate and eradicate tumors that are microscopic up to those with a diameter of 2.5 cm from the peritoneal surface following cytoreductive surgery (CRS).
Objectives:The study aimed to determine the efficacy and safety of CRS with HIPEC versus CRS alone for patients with epithelial ovarian, fallopian tube, and peritoneal cancer.
Materials and Methods:This retrospective cohort study included 50 patients (20 patients underwent CRS + HIPEC, while 30 patients underwent CRS alone). Records of these patients from January 2014 to June 2020 were reviewed, tabulated, and analyzed.
Results:The difference in recurrence rate between CRS with HIPEC and CRS alone was not statistically significant (50% vs. 43%, P = 0.774). The median time to recurrence was 10 and 9 months, respectively (P = 0.636). Five percent in the HIPEC group succumbed to the disease, while 13% died in the CRS alone group (P = 0.636). More post-operative complications were noted in the HIPEC group (45% vs. 10%, P = 0.007), but among these, only 2 cases had grade 3 to 4 complications (10%). The addition of HIPEC in the management of these patients resulted in a longer operative time (360 vs. 240 min, P < 0.001) and postoperative hospital stay (8 vs. 6 days, P = 0.026). There were no intra- or peri-operative mortalities in both groups.
Conclusion:CRS with HIPEC and CRS alone showed similar time to recurrence and recurrence rate. CRS with HIPEC had low risk of grade 3-4 complications and may still be considered as a treatment option for advanced, progressive, and recurrent epithelial ovarian, fallopian tube, and peritoneal cancer. - Full text:effect_of_cytoreductive_surgery.pdf
