Abstract
16077 Background: Much attention has been focused on the efficacy of radical surgery (RS) plus intraperitoneal hyperthermic perfusion (IPHP) in peritoneal carcinosis from recurrent OC. Methods: A pilot study aimed at analyzing the feasibility, morbidity, and toxicity of RS/IPHP and adjuvant chemotherapy has been carried out. Patients with recurrent, platinum-sensitive OC (PFI->6 months), have been enrolled. RS has been performed with peritonectomy procedures. The perfusion of the abdominal cavity has been achieved using 2 liters/m2 of 5% dextrose solution with oxaliplatin 460 mg/m2, preheated (41.5°C), and infused through the closed abdomen technique. After RS/IPHP, patients have received systemic chemotherapy with docetaxel (75 mg/mq), day 1, every 21 days, for 6 cycles. Results: As of December 2006, 14 patients underwent RS/IPHP: median age was 48.5 yrs (range 34–62). Ten (71.4%) patients had an ECOG PS=0. Median PFI was 24 months (range 7–72). TMedian value of PCI was 6 (range 2–10). Completeness of cytoreduction was 0 in 12 cases and 1 in 2 cases. Median EBL was 700 cc (range 400–1,600) and median number of blood transfusion was 3 (range 0–11). Median length of hospitalization was 15.5 days (range 8–27). We documented 3 cases of sepsis, 1 case of wound dehiscence requiring surgical intervention, 1 case of pleural effusion requiring thoracentesis, and 6 cases of post-operative haemorrhage, treated with surgical re-intervention (n=1), endoscopic cauterization (n=3), or blood transfusions (n=2). Ten patients underwent chemotherapy (total number of cycles= 49): grade 3 and 4 leukopenia occurred in 1, and 2 cases. Three patients (21.4%) experienced severe onicolysis and conjunctivitis. No deaths from this regimen was registered. With a median follow up of 7 months (range 1–18), 2 progressions of disease were observed. Conclusions: RS/IPHP utilizing intraperitoneal oxaliplatin followed by i.v. adjuvant docetaxel was shown to be a feasible approach to peritoneal recurrence of ovarian cancer. No significant financial relationships to disclose.
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