Eddy Cotte1,2, Olivier Glehen3,4, Faheez Mohamed5, Franck Lamy1,2, Claire Falandry2,6, François Golfier2,7, Francois Noel Gilly1,2. 1. Department of Oncologic Surgery, Centre Hospitalo-Universitaire Lyon Sud, 69495, Pierre Bénite, Cedex, France. 2. EA 3738, UCBL, Faculté de Médicine Lyon Sud, BP 12, 69921, Oullins, Cedex, France. 3. Department of Oncologic Surgery, Centre Hospitalo-Universitaire Lyon Sud, 69495, Pierre Bénite, Cedex, France. olivier.glehen@chu-lyon.fr. 4. EA 3738, UCBL, Faculté de Médicine Lyon Sud, BP 12, 69921, Oullins, Cedex, France. olivier.glehen@chu-lyon.fr. 5. School of Surgical and Reproductive Sciences, Newcastle upon Tyne, UK. 6. Department of Medical Oncology, CHLS-HCL, 69495, Pierre Bénite, Cedex, France. 7. Department of Gynecologic surgery, Centre Hospitalo-Universitaire Lyon Sud, 69495, Pierre Bénite, Cedex, France.
Abstract
PURPOSE: There is no standardized treatment for patients with chemo-resistant or recurrent advanced ovarian cancer. Locoregional treatments combining cytoreductive surgery and intraperitoneal chemohyperthermia (HIPEC) may improve survival for locoregional disease. PATIENTS AND METHODS: A prospective single center study of 81 patients with recurrent or chemo-resistant peritoneal carcinomatosis from ovarian cancer was performed. Patients were treated by maximal cytoreductive surgery combined with HIPEC (with cisplatinum at 20 mg/m(2)/L). A total of 47 patients were included for their third, fourth, fifth, sixth, or seventh surgical look. Altogether, 54 patients presented with extensive carcinomatosis (malignant nodules of >5 mm). RESULTS: Complete macroscopic resection (CCR-0) was achieved in 45 patients. Mortality and morbidity rates were 2.5% and 13.6%, respectively. With a median follow-up of 47.1 months, the overall and disease-free median survivals were 28.4 and 19.2 months, respectively. Carcinomatosis extent and completeness of cytoreduction (p = 0.02 and p <0.001, respectively) were identified as independent prognostic factors. For CCR-0 patients, overall and disease-free survivals were 54.9 and 26.9 months, respectively. CONCLUSION: Salvage therapy combining optimal cytoreductive surgery and HIPEC may achieve long-term survival in selected patients with recurrent or chemo-resistant ovarian cancer. This strategy may be most effective in patients with limited carcinomatosis or when cytoreductive surgery provides sufficient downstaging.
PURPOSE: There is no standardized treatment for patients with chemo-resistant or recurrent advanced ovarian cancer. Locoregional treatments combining cytoreductive surgery and intraperitoneal chemohyperthermia (HIPEC) may improve survival for locoregional disease. PATIENTS AND METHODS: A prospective single center study of 81 patients with recurrent or chemo-resistant peritoneal carcinomatosis from ovarian cancer was performed. Patients were treated by maximal cytoreductive surgery combined with HIPEC (with cisplatinum at 20 mg/m(2)/L). A total of 47 patients were included for their third, fourth, fifth, sixth, or seventh surgical look. Altogether, 54 patients presented with extensive carcinomatosis (malignant nodules of >5 mm). RESULTS: Complete macroscopic resection (CCR-0) was achieved in 45 patients. Mortality and morbidity rates were 2.5% and 13.6%, respectively. With a median follow-up of 47.1 months, the overall and disease-free median survivals were 28.4 and 19.2 months, respectively. Carcinomatosis extent and completeness of cytoreduction (p = 0.02 and p <0.001, respectively) were identified as independent prognostic factors. For CCR-0 patients, overall and disease-free survivals were 54.9 and 26.9 months, respectively. CONCLUSION: Salvage therapy combining optimal cytoreductive surgery and HIPEC may achieve long-term survival in selected patients with recurrent or chemo-resistant ovarian cancer. This strategy may be most effective in patients with limited carcinomatosis or when cytoreductive surgery provides sufficient downstaging.
Authors: G Panteix; A Beaujard; F Garbit; C Chaduiron-Faye; M Guillaumont; F Gilly; P Baltassat; F Bressolle Journal: Anticancer Res Date: 2002 Mar-Apr Impact factor: 2.480
Authors: Peter G Rose; Stacy Nerenstone; Mark F Brady; Daniel Clarke-Pearson; George Olt; Stephen C Rubin; David H Moore; James M Small Journal: N Engl J Med Date: 2004-12-09 Impact factor: 91.245
Authors: H Bonnefoi; R P A'Hern; C Fisher; V Macfarlane; D Barton; P Blake; J H Shepherd; M E Gore Journal: J Clin Oncol Date: 1999-03 Impact factor: 44.544
Authors: Robert E Bristow; Rafael S Tomacruz; Deborah K Armstrong; Edward L Trimble; F J Montz Journal: J Clin Oncol Date: 2002-03-01 Impact factor: 44.544
Authors: O Glehen; F Kwiatkowski; P H Sugarbaker; D Elias; E A Levine; M De Simone; R Barone; Y Yonemura; F Cavaliere; F Quenet; M Gutman; A A K Tentes; G Lorimier; J L Bernard; J M Bereder; J Porcheron; A Gomez-Portilla; P Shen; M Deraco; P Rat Journal: J Clin Oncol Date: 2004-08-15 Impact factor: 44.544
Authors: F N Gilly; P Y Carry; A C Sayag; A Brachet; G Panteix; B Salle; J Bienvenu; G Burgard; B Guibert; V Banssillon Journal: Hepatogastroenterology Date: 1994-04
Authors: Terence C Chua; Greg Robertson; Winston Liauw; Rhonda Farrell; Tristan D Yan; David L Morris Journal: J Cancer Res Clin Oncol Date: 2009-08-23 Impact factor: 4.553