959P - A prospective study to evaluate the role of Cytoreductive surgery (CRS)+ HIPEC in advanced epithelian ovarian malignancy -100 consecutive cases -IN...

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Ovarian Cancer
Gynaecologic Malignancies
Surgery and/or Radiotherapy of Cancer
Presenter SP Somashekhar
Citation Annals of Oncology (2017) 28 (suppl_5): v330-v354. 10.1093/annonc/mdx372
Authors R. Kumar C1, S. Somashekhar1, A. Rauthan2, R. Ashwin1, Y. Ramya1
  • 1Surgical Oncololgy, Manipal Comphrehensive Cancer Center, 560017 - Bengaluru/IN
  • 2Medical Oncology, Manipal Comphrehensive Cancer Center, 560017 - Bangalore/IN

Abstract

Background

To study the outcome and role of cytoreductive surgery (CRS) + HIPEC in advanced upfront and recurrent epithelial ovarian cancer.

Methods

100 consecutive patients with advanced epithelial ovarian cancer diagnosed between January 2011 to January 2017 were included in study after informed consent. IRB ethical clearance was obtained. All patients underwent CRS followed by HIPEC with dedicated machine (PERFORMER-HT) using only cisplatin 45mg/l for upfront and cisplatin 45mg/l and adriamycin 15mg/l in recurrent cases for 90 minutes in semi-open technique at 42 degrees Celsius. Descriptive study statistical analysis was done.

Results

Out of 100 patients, 74 were primary and 26 recurrent. Of 74 cases, 67.5% (n = 50) had upfront CRS+ HIPEC and 32.5% (n = 24) had interval CRS + HIPEC. Of 26 recurrent, 69.3% (n = 18) were platinum sensitive and 30.7% (n = 8) were platinum resistant. Median age 54.5(22-78) PCI 11.9(5-37) duration of surgery 9.5hrs (5-15),GI recovery 5.4 days, hospital stay 11.4 days. 12% (grade III) adverse morbidity and 3% 60 day mortality. Prolonged duration of surgery (p = 0.001), multivisceral resection (p = 0.039) hypoalbuminemia (p = 0.04) hypocalcemia (p = 0.01) were predictive factors for morbidity and prolonged hospital stay. With a median follow up of 50 months we had 6 systemic (3 lymph node, 2 bowel surface and 1 liver parenchyma) and 6 peritoneal recurrence and 7 deaths. Over all survival in primary was 70 months, platinum sensitive 32 months and platinum resistant 12 months.

Conclusions

CRS+HIPEC in advanced epithelial ovarian cancer can be done with accepted morbidity and mortality. Multivisceral resection, prolonged surgery, hypoalbuminemia, hypocalcemia were predictive factors for morbidity and prolonged hospital stay. Primary ovarian malignancies and platinum sensitive benefit the most with CRS + HIPEC whereas platinum resistant disease does not have any benefit.

Clinical trial identification

Legal entity responsible for the study

IRB ethical clerance, institional ethical board clerance

Funding

None

Disclosure

All authors have declared no conflicts of interest.