TY - JOUR
T1 - Minimally invasive secondary cytoreduction plus HIPEC for recurrent ovarian cancer
T2 - A case series
AU - Fagotti, A.
AU - Petrillo, M.
AU - Costantini, B.
AU - Fanfani, F.
AU - Gallotta, V.
AU - Chiantera, V.
AU - Turco, L. C.
AU - Bottoni, C.
AU - Scambia, G.
PY - 2014/2
Y1 - 2014/2
N2 - Objective To analyze the feasibility of laparoscopic/robotic secondary cytoreductive surgery and hyperthermic intraperitoneal intra-operative chemotherapy (SCS + HIPEC) in a retrospective series of isolated platinum sensitive recurrent ovarian cancer. Methods We retrospectively evaluated a consecutive series of ovarian cancer patients with isolated platinum sensitive relapse. Isolated relapse was defined as the presence of a single nodule, in a single anatomic site. In all cases the presence of isolated relapse was assessed at pre-operative FDG-PET/CT scan, and confirmed with staging laparoscopy performed immediately before SCS + HIPEC. Results 84 women with platinum sensitive relapse received SCS + HIPEC during a 4-year period. Among them, 10 cases (11.9%) showed isolated relapse and were treated with laparoscopic/robotic SCS + HIPEC. In all cases complete debulking was achieved. In HIPEC treatment, 9 women received cisplatin at 75 mg/m2, and the remaining patient oxaliplatin 460 mg/m2. In 7 patients SCS was performed through the laparoscopic route, and in 3 cases with a robotic approach. The median operative time from skin incision to the end of cytoreductive surgery was 122 min (95-140), estimated blood loss was 50 cm3 (50-100), and the median length of hospital stay was 4 days (3-7). The interval from surgery to adjuvant chemotherapy was 21 days (19-32). No grade 3/4 surgical, metabolic, or hematologic complications occurred. In all cases post-operative FDG-PET/CT scan was negative, and after a median time of 10 months (6-37) from SCS + HIPEC no secondary recurrence was observed. Conclusions Minimally invasive SCS + HIPEC can be safely performed in selected ovarian cancer patients with platinum sensitive isolated relapse.
AB - Objective To analyze the feasibility of laparoscopic/robotic secondary cytoreductive surgery and hyperthermic intraperitoneal intra-operative chemotherapy (SCS + HIPEC) in a retrospective series of isolated platinum sensitive recurrent ovarian cancer. Methods We retrospectively evaluated a consecutive series of ovarian cancer patients with isolated platinum sensitive relapse. Isolated relapse was defined as the presence of a single nodule, in a single anatomic site. In all cases the presence of isolated relapse was assessed at pre-operative FDG-PET/CT scan, and confirmed with staging laparoscopy performed immediately before SCS + HIPEC. Results 84 women with platinum sensitive relapse received SCS + HIPEC during a 4-year period. Among them, 10 cases (11.9%) showed isolated relapse and were treated with laparoscopic/robotic SCS + HIPEC. In all cases complete debulking was achieved. In HIPEC treatment, 9 women received cisplatin at 75 mg/m2, and the remaining patient oxaliplatin 460 mg/m2. In 7 patients SCS was performed through the laparoscopic route, and in 3 cases with a robotic approach. The median operative time from skin incision to the end of cytoreductive surgery was 122 min (95-140), estimated blood loss was 50 cm3 (50-100), and the median length of hospital stay was 4 days (3-7). The interval from surgery to adjuvant chemotherapy was 21 days (19-32). No grade 3/4 surgical, metabolic, or hematologic complications occurred. In all cases post-operative FDG-PET/CT scan was negative, and after a median time of 10 months (6-37) from SCS + HIPEC no secondary recurrence was observed. Conclusions Minimally invasive SCS + HIPEC can be safely performed in selected ovarian cancer patients with platinum sensitive isolated relapse.
KW - HIPEC
KW - Isolated platinum sensitive relapse
KW - Laparoscopy
KW - Minimally invasive surgery
KW - Ovarian cancer
KW - Robotic
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U2 - 10.1016/j.ygyno.2013.12.028
DO - 10.1016/j.ygyno.2013.12.028
M3 - Article
C2 - 24378877
AN - SCOPUS:84894042827
VL - 132
SP - 303
EP - 306
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 2
ER -