Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in epithelial ovarian cancer: State of the art

Table 1 Cytoreductive surgery + hyperthermic intraperitoneal chemotherapy in the treatment of advanced stage primary epithelial ovarian cancer: retrospective and observational studies: Study characteristics

Ref.	n	Disease stage	Setting of treatment	HIPEC drug and dose	Temp. (°C)	Duration of treatment (min)	Oncologic outcome	Common grade 2-3 toxicities	Mortality rate
Tentes et al[8]	43	“Locally advanced” ovarian cancer	23 primary	Doxorubicin 15 mg/m2 + Cisplatin 50 mg/m2 or Gemcitabine 1000 mg/m2	42.5-43	60 or 90	5-yr OS: 54%	Hematologic; GI; infectious	2 deaths (sepsis)
			20 recurrent				In primary population 5-yr OS 82.5%
Steller et al[31]	6	2-3 EOC	2 primary	Carboplatin 800-1200 mg/m2	42	90	All alive at 15 mo follow up; 5 without evidence of disease	Hematologic	No deaths
			4 recurrent
Piso et al[33]	19	3-4 EOC	8 primary	Cisplatin 75 mg/m2 + Mitoxantrone 15 mg/m2	41.5	90	Median PFS 18 mo; mean OS 33 mo; 5 yr survival 15%	Hematologic; GI (anastomotic leak, fistula); bleeding; abscess	1 death (sepsis)
			11 recurrent
Rufián et al[35]	33	3 EOC	19 primary	Paclitaxel 60 mg/m2	41-43	60	In primary population median relapse free survival was 25 mo; median OS 38 mo	Hematologic; infectious; GI (bleeding and perforation)	No deaths
			14 recurrent
Lentz et al[37]	25	3 EOC	11 primary	Carboplatin 400-1200 mg/m2	Inflow < 43.5	90	Not reported	One PE; one superficial wound dehiscence	No deaths
			14 recurrent
Pavlov et al[39]	56	3-4 EOC	31 primary	Doxorubicin 0.1 mg/kg + Cisplatin 15 mg/m2	40	180	Median OS 38.1 mo; 5-yr OS 67%	Hematologic; GI (anastomotic leak, obstruction)	1 death (CVA)
			25 recurrent

HIPEC: Hyperthermic intraperitonealchemotherapy; Temp.: Temperature; OS: Overall survival; GI: Gastrointestinal; EOC: Epithelial ovarian cancer; PFS: Progression free survival; PE: Pulmonary embolism; CVA: Cerebral-vascular accident.