Consolidation hyperthermic intraperitoneal chemotherapy and maintenance chemotherapy following laparoscopic cytoreductive surgery in the treatment of ovarian carcinoma

Purpose: Hyperthermic intraperitoneal chemotherapy (HIPEC) is an intriguing method of delivery wherein the cytotoxic agent is continuously heated and circulated throughout the peritoneum in an attempt to improve efficacy. Despite the potential of HIPEC in the treatment of ovarian cancer, there are limited safety, feasibility and survival data involving this procedure, particularly in conjunction with maintenance chemotherapy. Patients and methods: We retrospectively evaluated ovarian cancer patients who underwent laparoscopic debulking surgery, attained a complete response to their primary chemotherapy and subsequently received consolidation HIPEC with carboplatin area under the curve of 10 (AUC of 10) and a planned 12 cycles of paclitaxel (135 mg/m(2)) maintenance chemotherapy. The following demographic and clinical characteristics were abstracted: patient age, body mass index, surgery and pathology data, chemotherapy regimen, intra-operative results, toxicity, post-operative complications, length of hospital stay and disease-free/overall survival. Results: We identified 37 patients who were the subject of this study. There were no intra-operative complications during the administration of HIPEC; median estimated blood loss was 50 mL and length of hospital stay was 1.25 days. In the overall study population, six patients developed grade 3/4 anaemia and 24 patients exhibited grade <= 2 thrombocytopenia and neutropenia. Ten patients developed grade <= 2 nausea on postoperative day 1; there were no hospital readmissions. Median disease-free survival and overall survival was 13 months and 14 months, respectively. Conclusion: The results from this ovarian cancer treatment evaluation suggest that the combination of consolidation HIPEC and maintenance chemotherapy is feasible and reasonably well tolerated.