Intraperitoneal access via direct puncture is an alternative way to deliver intraperitoneal chemotherapy in ovarian, fallopian tube and primary peritoneal cancer

Objectives. Intraperitoneal (IP) chemotherapy has not been widely accepted in the treatment of ovarian cancer. One of the main reasons is the lack of a convenient and safe way to deliver IP therapy. The objective of this study was to investigate the feasibility of delivering IP chemotherapy via direct puncture using a peripheral venous needle, as well as evaluating the associated risk factors and complications in the primary treatment of ovarian, fallopian tube, and primary peritoneal cancer. Methods. The clinical records of all patients with stage II-IV epithelial ovarian, fallopian tube, and primary peritoneal cancer at Sun Yat-sen University Cancer Center from 01/1995 to 11/2006 were reviewed retrospectively to identify patients who had received IP therapy via direct puncture after primary cytoreduction. Results. We identified 194 patients, and 121 (62.4%) of them successfully completed six or more cycles of IP chemotherapy, whereas 73 (37.6%) failed. Two (1%) patients ceased IP therapy directly due to IP access related complications and 35 (18.1%) discontinued IP therapy for reasons unrelated to IP access. Old age might be a potential risk factor for IP therapy failure. The IP therapy failure rate in patients over 60 years old was higher than that in patients under or at 60 (57.1% versus 34.3%, P = 0.021). Body mass index were not associated with IP therapy failure. Conclusions. IP access via direct puncture using a peripheral venous needle could be an alternative and safe way to deliver IP chemotherapy in the primary treatment of ovarian cancer. (C) 2009 Elsevier Inc. All rights reserved.