Interval Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in First-Line Treatment for Advanced Ovarian Carcinoma: A Feasibility Study.
[en] [en] OBJECTIVES: We conducted a phase 2 trial to assess the feasibility of interval cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in patients with stage III and IV pleural ovarian carcinoma in first-line treatment with no macroscopic residual disease after surgery.
METHODS: Patients could be treated either with primary CS with HIPEC followed by 6 conventional cycles of chemotherapy or with 3 or 4 cycles of neoadjuvant chemotherapy before CS with HIPEC and 3 postoperative chemotherapy cycles. Hyperthermic intraperitoneal chemotherapy was performed with cisplatin (50 mg/m) for 60 minutes, only in case of complete cytoreduction.
RESULTS: Nineteen patients were included in the study, and they all underwent neoadjuvant chemotherapy before CS. Sixteen patients underwent complete CS with HIPEC. There was no mortality, and morbidity of CS with HIPEC was acceptable. The HIPEC procedure did not prevent the administration of the standard first-line treatment. In the 16 patients who underwent CS with HIPEC, the outcomes were very good.
CONCLUSION: Our study shows an acceptable toxicity of adding HIPEC to the standard first-line treatment in patients with stage III ovarian carcinoma treated with interval CS. Further studies are needed to confirm the role of HIPEC in the treatment of ovarian carcinoma.
Disciplines :
Oncology
Author, co-author :
D'Hondt, Véronique; *Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium, †Department of Surgical Oncology, Hôpital de la Citadelle, Liège, Belgium, ‡Biometrics Unit, Institut régional du Cancer de Montpellier (ICM), Montpellier, France, §Department of Medical Oncology, Hôpital de la Citadelle, Liège, Belgium, ∥Clinical Research Unit, Institut Jules Bordet, Brussels, Belgium, ¶Clinical Research Unit, Institut régional du Cancer de Montpellier (ICM), Montpellier, France, and #Department of Surgical Oncology, Institut Jules Bordet, Brussels, Belgium
Goffin, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR) ; Department of Surgical Oncology, Hôpital de la Citadelle, Liège, Belgium
Roca, Lise; Biometrics Unit, Institut Régional du Cancer de Montpellier (ICM), Montpellier Cedex 5, France
Dresse, Damien ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgie cardio-vasculaire et thoracique ; Department of Surgical Oncology, Hôpital de la Citadelle, Liège, Belgium
Leroy, Chantal; Department of Medical Oncology, Hôpital de la Citadelle, Liège, Belgium
Kerger, Joseph; Department of Medical Oncology, Institut Jules Bordet, Brussels, Belgium
Cordier, Lionel; Clinical Research Unit, Institut Jules Bordet, Brussels, Belgium
de Forges, Hélène; Clinical Research Unit, Institut Régional du Cancer de Montpellier (ICM), Montpellier, France
Veys, Isabelle; Department of Surgical Oncology, Institut Jules Bordet, Brussels, Belgium
Liberale, Gabriel; Department of Surgical Oncology, Institut Jules Bordet, Brussels, Belgium
Language :
English
Title :
Interval Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in First-Line Treatment for Advanced Ovarian Carcinoma: A Feasibility Study.
Coleman RL, Monk BJ, Sood AK, et al. Latest research and treatment of advanced-stage epithelial ovarian cancer. Nat Rev Clin Oncol. 2013;10:211-224.
Armstrong DK, Bundy B, Wenzel L, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006;354:34-43.
Alberts DS, Liu PY, Hannigan EV, et al. Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamid e for stage III ovarian cancer. N Engl J Med. 1996;335:1950-1955.
Markman M, Bundy BN, Alberts DS, et al. Phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderate ly high-dose carboplatin followed by intravenous paclitaxel and intraperitoneal cisplatin in small-volume stage III ovarian carcinoma: an intergroup study of the Gynecologic Oncology Group, Southwestern Oncology Group, and Eastern Cooperative Oncology Gro up. J Clin Oncol. 2001;19:1001-1007.
Tewari D, Java JJ, Salani R, et al. Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced o varian cancer: a Gynecologic Oncology Group study. J Clin Oncol. 2015;33: 1460-1466.
Glehen O, Mohamed F, Gilly FN. Peritoneal carcinomatosis from digestive tract cancer: new management by cytored uctive surgery and intraperitoneal chemohyperthermia. Lancet Oncol. 2004;5:219-228.
Vandervange N, Vangoethem A, Zoetmulder F, et al. Extensive cytoreductive surgery combined with intra-operative intraperitoneal perfusion with cisplatin under hyperthermic conditions (OVHIPEC) in patients with recurrent ovarian cancer: a feasibility pilot. Eur J Surg Oncol. 2000;26:663-668.
Piso P, Dahlke M-H, Loss M, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal car cinomatosis from ovarian cancer. World J Surg Oncol. 2004;2:21.
Raspagliesi F, Kusamura S, Campos Torres JC, et al. Cytoreduction combined with intraperitoneal hyperthermic perfusion chemother apy in advanced/recurrent ovarian cancer patients: the experience of National Cancer Institute of Milan. Eur J Surg Oncol. 2006;32:671-675.
Cotte E, Glehen O, Mohamed F, et al. Cytoreductive surgery and intraperitoneal chemohyperthermia for chemoresistant and recurrent advanced epithelial ovarian cancer: prospective study of 81 patients. World J Surg. 2007;31:1813-1820.
Argenta PA, Sueblinvon g T, Geller MA, et al. Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma: a pilot study. Gynecol Oncol. 2013;129:81-85.
Bakrin N, Bereder JM, Decullier E, et al. Peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced ovarian carcinoma: a FRENCH multicentre retrospective cohort study of 566 patients. Eur J Surg Oncol. 2013;39:1435-1443.
Rettenmaier MA, Mendivil AA, Abaid LN, et al. The feasibility of administering varying high-dose consolidation hyperthermic intrap eritoneal chemotherapy with carboplatin in the treatment of ovarian carcinoma. Arch Gynecol Obstet. 2014;291:1381-1386.
Safra T, Grisaru D, Inbar M, et al. Cytoreduction surgery with hyperthe rmic intraperitoneal chemotherapy in recurrent ovarian cancer improves progression-free survival, especially in BRCA-positive patients-A case-control study. J Surg Oncol. 2014;110:661-665.
Gonzalez Bayon L, Steiner MA, Vasquez Jimenez W, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial ovarian carcinoma: upfront therapy, at first recurrence, or later? Eur J Surg Oncol. 2013;39:1109-1115.
Le Brun J-F, Campion L, Berton-Rigaud D, et al. Survival benefit of hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer: a multi-institutional case control study Ann Surg Oncol. 2014;21:3621-3627.
Cascales-Campos PA, Gil J, Gil E, et al. Treatment of microscopic disease with hyperthermic intraoperative intraperitoneal chemotherapy after complete cyt oreduction improves disease-free survival in patients with stage IIIC/IV ovarian cancer. Ann Surg Oncol. 2014;21:2383-2389.
Roviello F,Roviello G,Petrioli R,et al. Hyperthermic intraperito neal chemotherapy for the treatment of ovarian cancer: a brief overview of recent results Crit Rev Oncol Hematol. 2015, 95, 297-305.
Chiva LM, Gonzalez-Martin A. A critical appraisal of hyperthermic i ntraperitoneal chemotherapy (HIPEC) in the treatment of advanced and recurrent ovarian cancer. Gynecol Oncol. 2015;136:130-135.
Lim MC, Kang S, Choi J, et al. Hyperthermic intraperitoneal che motherapy after extensive cytoreductive surgery in patients with primary advanced epithelial ovarian cancer: interim analysis of a phase II study. Ann Surg Oncol. 2009;16: 993-1000.
Di Giorgio A, Naticchioni E, Biacchi D, et al. Cytoreductive surgery (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of diffuse peritoneal carcinomatosis from ovarian cancer. Cancer. 2008;113:315-325.
Liu Y, Endo Y, Fujita T, et al. Cytoreductive surgery under aminolevulinic acid-mediated photodynamic diagnosis plus hyperthermic intraperitoneal che motherapy in patients with peritoneal carcinomatosis from ovarian cancer and primary peritoneal carcinoma: results of a phase I trial. Ann Surg Oncol. 2014;21:4256-4262.
Ansaloni L, Agnoletti V, Amado ri A, et al. Evaluation of extensive cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced epithelial ovarian cancer. Int J Gynecol Cancer. 2012;22:778-785.
Deraco M, Kusamura S,Virz?S, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as upfront therapy for advanced epithelial ovarian cancer: multi-institutional phase-II trial. Gynecol Oncol. 2011;122:215-220.
Pomel C, Ferron G, Lorimier G, et al. Hyperthermic intra-peritoneal chemotherapy using oxaliplatin as consolidation therapy for advanced epithelial ovarian carcinoma. Results of a phase II prospective multic entre trial. CHIPOVAC study. Eur J Surg Oncol. 2010;36:589-593.
Elias D, Liberale G, Manganas D, et al. Traitement chirurgical des carcinoses péritoneáles: 2 Y la chimiohyperthermie. A nn Chir. 2004;129:530-533.
Huo YR, Richards A, Liauw W, et al. Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) in ovarian cancer: a systematic review and meta-Ana lysis. Eur J Surg Oncol. 2015;41:1578-1589.
Passot G, Bakrin N, Roux AS, et al. Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: a prospective study of 216 patients. Eur J Surg Oncol. 2014;40:529-535.
Cascales-Campos P, Gil J, Gil E, et al. Cytoreduction and HIPEC after neoadjuvant chemotherapy in stage IIICYIVovarian cancer. Critical an alysis in elderly patients. Eur J Obstet Gynecol Reprod Biol. 2014;179:88-93.
