Annals of Surgical Oncology

, Volume 25, Issue 6, pp 1668–1675 | Cite as

Peritoneal Carcinomatosis of Rare Ovarian Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Multi-Institutional Cohort from PSOGI and BIG-RENAPE

  • Frédéric Mercier
  • Naoual Bakrin
  • David L. Bartlett
  • Diane Goere
  • François Quenet
  • Frédéric Dumont
  • Bruno Heyd
  • Karine Abboud
  • Christelle Marolho
  • Laurent Villeneuve
  • Olivier Glehen
  • the PSOGI Working Group
  • the BIG-RENAPE Working Group
Gynecologic Oncology



Ovarian cancer is the most common deadly cancer of gynecologic origin. Patients often are diagnosed at advanced stage with peritoneal metastasis. There are many rare histologies of ovarian cancer; some have outcomes worse than serous ovarian cancer. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can be considered for patients with recurrence. This study was designed to assess the impact of CRS and HIPEC on survival of patient with peritoneal metastasis from rare ovarian malignancy.


A prospective, multicentric, international database was retrospectively searched to identify all patients with rare ovarian tumor (mucinous, clear cells, endometrioid, small cell hypercalcemic, and other) and peritoneal metastasis who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI) and BIG-RENAPE working group. The postoperative complications, long-term results, and principal prognostic factors were analyzed.


The analysis included 210 patients with a median follow-up of 43.5 months. Median overall survival (OS) was 69.3 months, and the 5-year OS was 57.7%. For mucinous tumors, median OS and DFS were not reached at 5 years. For granulosa tumors, median overall survival was not reached at 5 years, and median DFS was 34.6 months. Teratoma or germinal tumor showed median overall survival and DFS that were not reached at 5 years. Differences in OS were not statistically significant between histologies (p = 0.383), whereas differences in DFS were (p < 0.001).


CRS and HIPEC may increases long-term survival in selected patients with peritoneal metastasis from rare ovarian tumors especially in mucinous, granulosa, or teratoma histological subtypes.



The authors thank Peggy Jourdan-Enfer and Anaïs Poulet for their help with data collection.


The authors report no conflicts of interest relevant to this article.


The collaborators of the BIG-RENAPE Working Group include the following: J. Abba (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); C. Arvieux (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); J-M. Bereder (Department of Surgical Oncology, CHU L’Archet 2, Nice, France); D. Bouzard (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); C. Brigand (Department of Surgical Oncology, CHRU Hautepierre, Strasbourg, France); S. Carrère (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); C. Eveno (Department of Surgical Oncology, CHU Lariboisière, Paris, France); O. Facy (Department of Surgical Oncology, CHU Dijon, Dijon, France); G. Ferron (Department of Surgical Oncology, IUCT Oncopole, Toulouse, France); F. Guyon (Department of Surgical Oncology, Institut Bergonié, Bordeaux, France); R. Kianmanesh (Department of Surgical Oncology, CHU Robert Debré, Reims, France); R. Lo Dico (Department of Surgical Oncology, CHU Lariboisière, Paris, France); G. Lorimier (Department of Surgical Oncology, ICO-Paul Papin, Angers, France); F. Marchal (Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France); P. Mariani (Department of Surgical Oncology, Institut Curie, Paris, France); P. Meeus (Department of Surgical Oncology, Centre Léon Bérard, Lyon, France); S. Msika (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); P. Ortega-Deballon (Department of Surgical Oncology, CHU Dijon, Dijon, France); B. Paquette (Department of Digestive Surgery, Minjoz University Hospital, Besançon, France); N. Pirro (Department of Surgical Oncology, CHU La Timône, Marseille, France); M. Pocard (Department of Surgical Oncology, CHU Lariboisière, Paris, France); P. Rat (Department of Surgical Oncology, CHU Dijon, Dijon, France); O. Sgarbura (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); E. Thibaudeau (Department of Surgical Oncology, ICO–René Gauducheau, St Herblain, France); F. Zinzindohoue (Department of Surgical Oncology, Hôpital Européen Georges Pompidou, Paris, France).

The collaborators of the PSOGI Working Group included the following: S. A. Ahrendt (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); E. Akaishi (Department of Surgical Oncology, Centro de Oncologia Hospital Sirio Libanes, Sao Paulo, Brazil); A. Bhatt (Department of Surgical Oncology, Fortis Hospitals Limited, Bangalore, India); P. Cachin (Department of Surgery, Akademiska sjukhuset, Uppsala University Hospital, Uppasala, Sweden); W. Ceelen (Department of Gastrointestinal Surgery, Gent University Hospital, Ghent, Belgium); R. P. Edwards (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); M. P. Holtzman (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); D. Kecmanovic (Department of Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia); K. W. Lee (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); E. A. Levine (Department of Surgical Sciences-Oncology, Wake Forest Baptist Medical Center, Winston Salem, USA); S. Mehta (Division of Peritoneal Surface Oncology, Saifee Hospital, Mumbai, India); D. L. Morris (Department of Surgery, University of New South Wales, Sidney, Australia); P. K. Pande (Department of Surgical Oncology, BLK Superspeciality Hospital, New Delhi, India); P. Piso (Department of Surgery, University of Regensburg, Regensburg, Germany); S. O’Dwyer (Department of Colorectal Surgery, Christie Cancer Center, Manchester, United Kingdom); J. F. Pingpank (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA); F. Rajan (Department of Surgical Oncology, Kovai Medical Centre, Coimbatore, India); B. Rau (Department of Surgical Oncology, Charite Campus Mitte University of Berlin, Berlin, Germany); J. Spiliotis (First Department of Surgical Oncology, Metaxa Cancer Memorial Hospital, Piraeus, Greece); P. Sugarbaker (Department of Surgical Oncology, Washington Hospital Center, United States); M. Teo (Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore); R. Yarema (Department of Oncology and Medical Radiology Danylo Halytsky Lviv National Medical University, Lviv, Ukraine); Y. Yonemura (Department of Surgical Oncology, Organization to Support Peritoneal Dissemination Treatment, Osaka, Japan); H. J. Zeh (Department of Surgical Oncology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA).

Supplementary material

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Supplementary material 1 (PPTX 55 kb)
10434_2018_6464_MOESM2_ESM.docx (77 kb)
Supplementary material 2 (DOCX 76 kb)


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Frédéric Mercier
    • 1
  • Naoual Bakrin
    • 1
    • 2
  • David L. Bartlett
    • 3
  • Diane Goere
    • 4
  • François Quenet
    • 5
  • Frédéric Dumont
    • 6
  • Bruno Heyd
    • 7
  • Karine Abboud
    • 8
  • Christelle Marolho
    • 9
  • Laurent Villeneuve
    • 2
    • 9
  • Olivier Glehen
    • 1
    • 2
  • the PSOGI Working Group
  • the BIG-RENAPE Working Group
  1. 1.Department of Surgical OncologyCentre Hospitalier Lyon SudPierre-BéniteFrance
  2. 2.EMR 3738, Lyon 1 UniversityLyonFrance
  3. 3.Department of Surgical OncologyUniversity of Pittsburgh School of MedicinePittsburghUSA
  4. 4.Department of Surgical OncologyGustave RoussyVillejuif CedexFrance
  5. 5.Department of SurgeryInstitut Du Cancer de MontpellierMontpellierFrance
  6. 6.Department of Surgical OncologyICO René Gauducheau Cancer CenterSaint-HerblainFrance
  7. 7.Department of Digestive SurgeryMinjoz University HospitalBesançonFrance
  8. 8.Department of General SurgerySt Etienne University HospitalSaint-ÉtienneFrance
  9. 9.Unité de Recherche CliniqueHospices Civils de Lyon, Pôle Information Médicale Evaluation RechercheLyonFrance

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