CRS + HIPEC in stage IIIc epithelial ovarian cancer and comparison of oncological outcome only with CRS and IV chemotherapy and CRS + IP chemotherapy.

Abstract

e18054 Background: Our study aims to describe role of CRS & HIPEC in stage IIIC epithelial ovarian malignancy & compare the oncological outcome (DFS & OS) of extensive CRS+ HIPEC in comparison with CRS & IV chemotherapy & CRS + IP chemotherapy. Methods: Patients diagnosed of stage IIIc EOC underwent extensive CRS + HIPEC. All data prospectively entered in the HIPEC registry was analysed. Outcome of CRS & IV group (n = 50), CRS + IP group (n = 60) operated around same period was compared with the CRS & HIPEC group. Results: Out of 135 patients, upfront, interval and secondary cytoreduction plus HIPEC was done in 29.6%, 44.4% & 25.9% & mean PCI was 14.1, 9.6 & 13.0 respectively. Multi-visceral resection, diaphragmatic resection & bowel resection was required in 12.7%, 50% & 41.8% respectively. Overall G3- G5 morbidity was seen in 25.4% with major being electrolyte imbalance 16.3%, hematological 12.7% & surgical 11.8%. Mean ICU & hospital stay 1.5 & 11 days respectively. Overall 30 day mortality was 4.5%. With a median follow up of 42 months DFS was 30, 33 & 16 months and OS was 70%, 67% & 51% at 4 year for upfront, interval and the recurrent settings respectively. Detailed description presented in Table. Most of the recurrences in CRS & IV group were in peritoneum whereas the other two groups had lesser peritoneal & systemic recurrence. Conclusions: Optimal cytoreduction & some form of IP therapy is needed to improve outcomes. CRS+ HIPEC is feasible in all groups of ovarian cancer with acceptable morbidity & mortality. However the role of single HIPEC in comparison to 6 cycles of IP chemotherapy needs to be evaluated with a well-designed multi-institutional randomised study. [Table: see text]