Peritoneal Carcinomatosis from Ovarian Epithelial Primary: Combined Aggressive Treatment

Francesco Cavaliere, Diana Giannarelli, Mario Valle, Orietta Federici, Gianluca Liotta, Pasquale Perri, Franco Di Filippo, Alfredo Garofalo, Pasquale Ialongo

Research output: Contribution to journalArticlepeer-review

Abstract

Cytoreductive surgery followed by platinum based systemic chemotherapy is an effective treatment for advanced ovarian epithelial carcinoma, resulting in up to 80% complete response (CR) rate; however only 30% of patients reaches 5-year survival. The low extra-abdominal relapse attitude leads to consider the opportunity of treatment intensification combining aggressive cytoreductive surgery with locoregional chemotherapy for FIGO stage HI/IV ovarian carcinoma recurrent after the first-line chemotherapy, having still a curative intent. Patients and Methods:An "open" intra-abdominal hyperthermicperfusion with 25 mglm2lit cisplatin of perfusate or 50 mglm 2 cisplatin plus 15 mglm 2 doxorubicin was carried out throughout the abdomino-pelvic cavity on 42 patients affected by peritoneal carcinomatosis from ovarian primary, soon after tumor removal en bloc with regional involved peritoneum. Clinical and oncologic data have been prospectively recorded on a dedicated database. Results: Forty-two patients, submitted to peritonectomy, achieved no residual macroscopic disease in 83% of the cases. Hyperthermic chemoperfusion was performed in 95% of the patients. Major complications were observed in 21.4%, being directly correlated to the duration of the surgical procedure (p=0.03). The operative mortality was 4.7% . At a mean follow up of 22 months, the overall 3-year survival was 61.4%, with a median survival of 41 months. Conclusion: Complete cytoreduction is possible for the majority of patients, allowing encouraging survival to be reached. Careful selection of patients could reduce surgical risk and further improve survival.

Original languageEnglish
Pages (from-to)441-446
Number of pages6
JournalIn Vivo
Volume23
Issue number3
Publication statusPublished - May 2009

Keywords

  • Hyperthermic perfusion
  • Ovarian cancer
  • Peritoneal carcinomatosis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Pharmacology

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