The use of cisplatin plus doxorubicin or paclitaxel in hyperthermic intraperitoneal chemotherapy (HIPEC) for stage IIIC or IV epithelial ovarian cancer: a comparative study
- 153 Downloads
Our main aim is to analyze the survival results in women operated on for advanced ovarian cancer with two different HIPEC regimens (cisplatin plus doxorubicin versus paclitaxel).
Patients and methods
A prospective cohort of patients with stage IIIC or IV epithelial ovarian cancer operated on with cytoreductive surgery and HIPEC, from October-2008 to February-2016, was retrospectively analyzed. The two drugs used, cisplatin/doxorubicin (Group A) and paclitaxel (Group B), were compared.
Forty-one patients were treated with cytoreductive surgery and HIPEC; 19 patients (46%) were in Group A and 22 (54%) were in Group B. The extent of peritoneal disease was comparable between groups (Peritoneal Cancer Index of 10 in Group A versus PCI of 12.5 in Group B). There were no differences in morbidity between groups, with a severe morbidity (Dindo–Clavien III or IV) of 36.8% versus 27.3%, respectively. There was no postoperative mortality. Median follow-up was 39 months. Median overall survival was 79 months. Overall survival at 3 years in Group A was 66% versus 82.9% in Group B (p = 0.248). Incomplete cytoreduction (macroscopic residual tumour after surgery) was identified as the only independent factor that influenced overall survival (HR 12.30, 95% CI 1.28–118.33, p = 0.03). The cytostatic used in HIPEC had no influence in overall survival.
The cytostatic used in HIPEC did not have a negative effect in the prognosis of patients with advanced ovarian cancer.
KeywordsPeritoneal carcinomatosis Ovarian cancer HIPEC Chemotherapy Cytostatic agents
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The current study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
All the patients included in the study have signed an informed consent for the intervention, in which they have indicated their implicit consent for the collection of data for future oncological analyzes.
- 3.Cascales-Campos P, López-López V, Gil J, Arevalo-Perez J, Nieto A, Barceló F, et al. Hyperthermic intraperitoneal chemotherapy with paclitaxel or cisplatin in patients with stage III-C/IV ovarian cancer. Is there any difference? Surg Oncol. 2016;25(3):164–70.Google Scholar
- 8.Cascales PA, Gil J, Galindo PJ, Machado F, Frutos IM, Paricio PP. Heterogeneity in patients and methods. A problem for hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) in ovarian carcinoma. Eur J Obstet Gynecol Reprod Biol. 2011;158(2):361–2.Google Scholar
- 13.Markman M, Bundy BN, Alberts DS, Fowler JR, Clark-Pearson DL, Carson LF, et al. Phase III trial of standard-dose intravenous cisplatin plus paclitaxel versus moderately 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 Group. J Clin Oncol. 2001;19(4):1001–7.CrossRefPubMedGoogle Scholar
- 17.Cascales-Campos PA, Gil J, Gil E, Feliciangeli E, Gonzalez-Gil A, Parrilla JJ, et al. Treatment of microscopic disease with hyperthermic intraoperative intraperitoneal chemotherapy after complete cytoreduction improves disease-free survival in patients with stage IIIC/IV ovarian cancer. Ann Surg Oncol. 2014;21(7):2383–9.CrossRefPubMedGoogle Scholar
- 21.Bakrin N, Bereder JM, Decullier E, Classe JM, Msika S, Lorimier G, 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(12):1435–43.CrossRefPubMedGoogle Scholar
- 22.Gonzalez Bayon L, Steiner MA, Vasquez Jimenez W, Asencio JM, Alvarez de Sierra P, Atahualpa Arenas F, 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(10):1109–15.Google Scholar
- 25.Manzanedo I, Pereira F, Perez-Viejo E, Serrano A, Hernández-García M, Martínez-Torres B, et al. Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) with primary or secondary cytoreductive surgery in the treatment of advanced epithelial ovarian cancer. Minerva Ginecol. 2017;69(2):119–27.PubMedGoogle Scholar
- 27.Van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med. 2018;378(3):230–40.Google Scholar