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Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico

Received: 15 July 2013     Published: 20 August 2013
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Abstract

Background: Ovarian cancer is a lethal tumor, 70% of which occurs in locally advanced stages. Despite its high initial response rate to chemotherapy, recurrence takes place in up to 90%. Prognosis of recurrent disease remains poor. In recent years, a new approach has been developed, combining a maximal cytoreductive effort with Hyperthermic intraperitoneal chemotherapy (HIPEC).Methods: We conducted a pilot study of 14 patients with recurrent ovarian cancer who were treated with Cytoreductive surgery (CRS) and HIPEC at the Mexico City-based National Cancer Institute of México (INCan) between January 2007 and January 2012.Results: There were 14 patients with recurrent ovarian cancer, including 13 with clinical stage IIIC and one with clinical stage CEIV due to retroperitoneal tumor with recurrence. Average age was 52 years (range, 20–72 years). Mortality and morbidity rates were 0 and 40%, respectively. Average surgical operative time was 7.5 h (range, 4.7–11 h). Average bleeding amounted to 1,171 mL (range, 100–3,700 mL).Overall median survival (OMS) was 14 months (range, 2–37 months). Peritoneal carcinomatosis index (PCI) showed eight patients with <20 and six with >20 points. Bleeding correlates with the PCI of >20 points. Performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (PCI, >20).Conclusions: Therapy combining CRS and HIPEC is feasible in selected patients with recurrent ovarian carcinoma with high morbidity. With ovarian cancer, novel therapies should be explored, one of which could be HIPEC.

Published in Advances in Surgical Sciences (Volume 1, Issue 2)
DOI 10.11648/j.ass.20130102.11
Page(s) 6-10
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2013. Published by Science Publishing Group

Keywords

Cytoreductive Surgery, HIPEC, Recurrent Ovarian Cancer, Cisplatin

References
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    Horacio Noé López-Basave, Flavia Morales-Vásquez, Juan M. Medina-Castro, Isaías Padilla-Mota, Juan M. Ruiz-Molina. (2013). Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico. Advances in Surgical Sciences, 1(2), 6-10. https://doi.org/10.11648/j.ass.20130102.11

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    ACS Style

    Horacio Noé López-Basave; Flavia Morales-Vásquez; Juan M. Medina-Castro; Isaías Padilla-Mota; Juan M. Ruiz-Molina. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico. Adv. Surg. Sci. 2013, 1(2), 6-10. doi: 10.11648/j.ass.20130102.11

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    AMA Style

    Horacio Noé López-Basave, Flavia Morales-Vásquez, Juan M. Medina-Castro, Isaías Padilla-Mota, Juan M. Ruiz-Molina. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico. Adv Surg Sci. 2013;1(2):6-10. doi: 10.11648/j.ass.20130102.11

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  • @article{10.11648/j.ass.20130102.11,
      author = {Horacio Noé López-Basave and Flavia Morales-Vásquez and Juan M. Medina-Castro and Isaías Padilla-Mota and Juan M. Ruiz-Molina},
      title = {Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico},
      journal = {Advances in Surgical Sciences},
      volume = {1},
      number = {2},
      pages = {6-10},
      doi = {10.11648/j.ass.20130102.11},
      url = {https://doi.org/10.11648/j.ass.20130102.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20130102.11},
      abstract = {Background: Ovarian cancer is a lethal tumor, 70% of which occurs in locally advanced stages. Despite its high initial response rate to chemotherapy, recurrence takes place in up to 90%. Prognosis of recurrent disease remains poor. In recent years, a new approach has been developed, combining a maximal cytoreductive effort with Hyperthermic intraperitoneal chemotherapy (HIPEC).Methods: We conducted a pilot study of 14 patients with recurrent ovarian cancer who were treated with Cytoreductive surgery (CRS) and HIPEC at the Mexico City-based National Cancer Institute of  México (INCan) between January 2007 and January 2012.Results: There were 14 patients with recurrent ovarian cancer, including 13 with clinical stage IIIC and one with clinical stage CEIV due to retroperitoneal tumor with recurrence. Average age was 52 years (range, 20–72 years). Mortality and morbidity rates were 0 and 40%, respectively. Average surgical operative time was 7.5 h (range, 4.7–11 h). Average bleeding amounted to 1,171 mL (range, 100–3,700 mL).Overall median survival (OMS) was 14 months (range, 2–37 months). Peritoneal carcinomatosis index (PCI) showed eight patients with 20 points. Bleeding correlates with the PCI of >20 points. Performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (PCI, >20).Conclusions: Therapy combining CRS and HIPEC is feasible in selected patients with recurrent ovarian carcinoma with high morbidity. With ovarian cancer, novel therapies should be explored, one of which could be HIPEC.},
     year = {2013}
    }
    

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  • TY  - JOUR
    T1  - Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico
    AU  - Horacio Noé López-Basave
    AU  - Flavia Morales-Vásquez
    AU  - Juan M. Medina-Castro
    AU  - Isaías Padilla-Mota
    AU  - Juan M. Ruiz-Molina
    Y1  - 2013/08/20
    PY  - 2013
    N1  - https://doi.org/10.11648/j.ass.20130102.11
    DO  - 10.11648/j.ass.20130102.11
    T2  - Advances in Surgical Sciences
    JF  - Advances in Surgical Sciences
    JO  - Advances in Surgical Sciences
    SP  - 6
    EP  - 10
    PB  - Science Publishing Group
    SN  - 2376-6182
    UR  - https://doi.org/10.11648/j.ass.20130102.11
    AB  - Background: Ovarian cancer is a lethal tumor, 70% of which occurs in locally advanced stages. Despite its high initial response rate to chemotherapy, recurrence takes place in up to 90%. Prognosis of recurrent disease remains poor. In recent years, a new approach has been developed, combining a maximal cytoreductive effort with Hyperthermic intraperitoneal chemotherapy (HIPEC).Methods: We conducted a pilot study of 14 patients with recurrent ovarian cancer who were treated with Cytoreductive surgery (CRS) and HIPEC at the Mexico City-based National Cancer Institute of  México (INCan) between January 2007 and January 2012.Results: There were 14 patients with recurrent ovarian cancer, including 13 with clinical stage IIIC and one with clinical stage CEIV due to retroperitoneal tumor with recurrence. Average age was 52 years (range, 20–72 years). Mortality and morbidity rates were 0 and 40%, respectively. Average surgical operative time was 7.5 h (range, 4.7–11 h). Average bleeding amounted to 1,171 mL (range, 100–3,700 mL).Overall median survival (OMS) was 14 months (range, 2–37 months). Peritoneal carcinomatosis index (PCI) showed eight patients with 20 points. Bleeding correlates with the PCI of >20 points. Performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (PCI, >20).Conclusions: Therapy combining CRS and HIPEC is feasible in selected patients with recurrent ovarian carcinoma with high morbidity. With ovarian cancer, novel therapies should be explored, one of which could be HIPEC.
    VL  - 1
    IS  - 2
    ER  - 

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Author Information
  • Department of SurgicalOncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

  • Department of SurgicalOncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

  • Department of SurgicalOncology, Centro Oncologico Estatal,Instituto de Seguridad Social del Estado de México y Municipios (ISSEMYM), Toluca, Edo. de México, Mexico

  • Department of SurgicalOncology, Centro Oncologico Estatal,Instituto de Seguridad Social del Estado de México y Municipios (ISSEMYM), Toluca, Edo. de México, Mexico

  • Department of SurgicalOncology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

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