Perioperative fast track program in intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery in advanced ovarian cancer

Abstract Introduction Diffuse peritoneal dissemination in advanced ovarian cancer can be treated using optimal effort surgery involving peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). Objective To report on our experience in the tr...

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Published in:	European journal of surgical oncology Vol. 37; no. 6; pp. 543 - 548
Main Authors:	Cascales Campos, P.A, Gil Martínez, J, Galindo Fernández, P.J, Gil Gómez, E, Martínez Frutos, I.M, Parrilla Paricio, P
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-06-2011 WB Saunders
Subjects:	Adult Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Carcinoma - drug therapy Carcinoma - secondary Carcinoma - surgery Carcinoma - therapy Chemotherapy, Adjuvant Fast track Female Hematology, Oncology and Palliative Medicine HIPEC Humans Hyperthermia, Induced Intestines - surgery Intraoperative Period Lymph Node Excision Middle Aged Morbidity Neoplasm Staging Ovarian cancer Ovarian Neoplasms - drug therapy Ovarian Neoplasms - pathology Ovarian Neoplasms - surgery Ovarian Neoplasms - therapy Ovariectomy - methods Peritoneal Neoplasms - drug therapy Peritoneal Neoplasms - secondary Peritoneal Neoplasms - surgery Peritoneal Neoplasms - therapy Postoperative Complications - epidemiology Postoperative Complications - etiology Splenectomy Surgery Treatment Outcome HIPEC Fast track Ovarian cancer Medicine
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Summary:	Abstract Introduction Diffuse peritoneal dissemination in advanced ovarian cancer can be treated using optimal effort surgery involving peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). Objective To report on our experience in the treatment of advanced ovarian cancer using peritonectomy procedures and HIPEC through the fast track program. Patients and method From September 2008 until May 2010, forty-six patients with primary advanced (stage III-C) or recurrent ovarian cancer have been included in the fast track protocol if they had optimal cytoreduction CC-0 or CC-1 accompanied by HIPEC and there had no more than one digestive anastomosis. Results The mean peritoneal cancer index (PCI) was 12.35 (3–21). The median operation time was 380 min (200–540). Optimal surgery CC-0 was achieved in 38 of the 46 patients and CC-1 in the remaining 8. Mean postoperative hospital stay was 6.94 ± 1.56 days (3–11). Major morbidity rates were 15.3%. Paralytic ileus was the most frequent of these. There was no mortality related to the procedure. Conclusion Surgery with peritonectomy procedures and HIPEC in advanced ovarian carcinoma is possible under fast track surgery programs in patients with low volume peritoneal carcinomatosis. Prospective and randomized studies are needed.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0748-7983 1532-2157
DOI:	10.1016/j.ejso.2011.03.134