Journal of Clinical Oncology, 2009 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 27, No 15S (May 20 Supplement), 2009: 5524
© 2009 American Society of Clinical Oncology

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chua, T. C. Articles by Morris, D. L. Search for Related Content PubMed Articles by Chua, T. C. Articles by Morris, D. L.

Abstract

Systematic review of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for ovarian peritoneal carcinomatosis: A more efficacious way of delivering intraperitoneal chemotherapy

St George Hospital, Sydney, Australia

5524

Background: Advanced and recurrent ovarian cancer results in extensive dissemination of tumor within the peritoneal cavity. The current evidence suggests that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) may be a feasible option with potential benefits compared to the current standard of care in the treatment of peritoneal carcinomatosis from ovarian cancer. Methods: A systematic review of relevant studies before August 2008 was undertaken to document and report its efficacy. Each study was appraised using a predetermined protocol. The quality of studies was assessed. The patient characteristics, protocol of treatment, perioperative morbidity and mortality, and treatment outcomes were synthesized through a narrative review with full tabulation of results of all included studies. Results: In total, 15 non-randomized, observational studies were reviewed, comprising of 512 patients. All patients received HIPEC as part of the combined treatment with cytoreductive surgery. Cisplatin was the most common chemoperfusate. The mortality associated with the treatment ranged from 0 to 10%. The rates of severe morbidity ranged from 0 to 40%. The median time of follow up ranged from 14 to 64 months, the median disease-free survival ranged from 10 to 57 months and the overall median survival ranged from 22 to 64 months. In patients who had an optimal cytoreduction, the median survival ranged from 29 to 66 months, with a 3- and 5-year survival rate that ranged from 35 to 63% and 12 to 66%, respectively. Conclusions: The future for cytoreductive surgery and HIPEC in ovarian cancer is promising. More studies are called for to validate the efficacy of this treatment. For it to become generally accepted, the oncology community must commit to a randomized trial. Before this, the current treatment of cytoreductive surgery combined with adjuvant intraperitoneal and intravenous chemotherapy should remain the mainstay of treatment.

No significant financial relationships to disclose.

Abstract presentation from the 2009 ASCO Annual Meeting