Different sequential approaches of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in treating ovarian cancer with malignant ascites

作者：Ba, Mingchen^*; Long, Hui; Zhang, Xiangliang; Tang, Yunqiang; Wu, Yinbing; Yu, Feihong; Wang, Shuai; Cui, Shuzhong

来源：Journal of Cancer Research and Clinical Oncology, 2014, 140(9): 1497-1506.

DOI：10.1007/s00432-014-1692-5

• Hyperthermic intraperitoneal chemotherapy
• Ultrasonography
• Cytoreductive surgery
• Ovarian cancer
• Carcinomatosis
• Malignant ascites

Treatment for malignant ascites in advanced ovarian cancer (OC) patients remains controversial. The objective of this study was to investigate the efficacy of combined continuous circulatory hyperthermic intraperitoneal chemotherapy (HIPEC) preceded or followed by cytoreductive surgery (CRS) for malignant ascites in OC patients.
Female OC patients (n = 32) with malignant ascites were divided based on stable (n = 17) or unstable (n = 15) vital signs. Stable patients were treated with CRS immediately followed by HIPEC (CRS + HIPEC). Unstable patients were treated using B-mode ultrasound-guided HIPEC followed by delayed CRS upon vital sign stability (HIPEC + dCRS). All patients were followed up until death or until December 2012.
Median follow-up was 29 months. All patients showed ascite regression [objective remission rates (ORR) = 100 %]. Among stable patients, CRS + HIPEC was successful in 14/17 (83.4 %). Among unstable patients, HIPEC + dCRS was successful in 13/15 (86.7 %). Median survival times were 19 and 17 months in the stable and unstable groups, respectively. No significant differences in CRS rates, ascites ORR, Karnofsky performance status scores, or survival rates were observed between groups (P > 0.05).
Cytoreductive surgery with immediate HIPEC and HIPEC with dCRS, determined by vital sign stability, may lead to similar outcomes in OC patients with malignant ascites.

• 出版日期2014-9
• 单位广州市皮肤病防治所; 广州医科大学