Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers: Is there a role?

Michelle M. Boisen, Scott D. Richard, Matthew P. Holtzman, Robert P. Edwards, Joseph L. Kelley, Mohammad Haroon Choudry, David Bartlett, Marilyn Huang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is often used to treat gastrointestinal malignancies and is of interest in epithelial ovarian cancer (EOC) given the propensity for intraperitoneal spread. The role of HIPEC in the treatment of gynecologic malignancies is not well defined. We sought to describe clinical characteristics and outcomes of our patient population treated with HIPEC. Methods: IRB approval was obtained. Patients diagnosed with EOC and treated with HIPEC from January 2007 until December 2013 were identified using a prospectively maintained HIPEC database. Patient charts were abstracted to identify patient demographic information, treatment characteristics, and outcome data. Statistical analysis was descriptive. Results: Thirty-four patients were identified. Mean age at diagnosis was 56.5 years. The majority of cases (28, 82%) were of serous histology. The indications for HIPEC administration were as follows: 9% primary treatment, 41% first recurrence, 26% second recurrence, and 24% consolidative therapy in the setting of primary or recurrent disease. The majority of patients (21, 62%) received mitomycin C. The other drugs administered include cisplatin (10, 29%), oxaliplatin (2, 6%), and carboplatin (1, 3%). Mean length of hospital stay was 9 days (range, 3-39 days). The rates of postoperative bacteremia and hematologic toxicity were 6% and 54%, respectively. Seven (21%) patients developed transient renal dysfunction, and this was seen almost exclusively in the patients who received cisplatin. One (3%) additional patient had renal dysfunction that persisted longer than 30 days post-operative but did not go on to require dialysis. There were no perioperative deaths in this cohort. Eleven (32%) patients received additional chemotherapy following HIPEC administration. At a median follow-up of 20 months (range, 3-87 months), eight patients are alive with disease, seven have no evidence of disease, 14 have died of their disease, and five patients have been lost to follow-up. Conclusions: This data supports a reasonable side effect profile of treatment of EOC with HIPEC. Prospective studies are needed to elucidate the optimal drug and patient population that would derive the most benefit from treatment with HIPEC.

Original languageEnglish (US)
Pages (from-to)10-17
Number of pages8
JournalJournal of Gastrointestinal Oncology
Volume7
Issue number1
DOIs
StatePublished - 2016
Externally publishedYes

Fingerprint

Drug Therapy
oxaliplatin
Ovarian epithelial cancer
Cisplatin
Length of Stay
Kidney
Therapeutics
Recurrence
Research Ethics Committees
Carboplatin
Lost to Follow-Up
Mitomycin
Bacteremia
Pharmaceutical Preparations
Population
Dialysis
Neoplasms
Histology
Demography
Databases

Keywords

  • Chemotherapy
  • Epithelial ovarian cancer (EOC)
  • Intraperitoneal infusions

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers : Is there a role? / Boisen, Michelle M.; Richard, Scott D.; Holtzman, Matthew P.; Edwards, Robert P.; Kelley, Joseph L.; Choudry, Mohammad Haroon; Bartlett, David; Huang, Marilyn.

In: Journal of Gastrointestinal Oncology, Vol. 7, No. 1, 2016, p. 10-17.

Research output: Contribution to journalArticle

Boisen, MM, Richard, SD, Holtzman, MP, Edwards, RP, Kelley, JL, Choudry, MH, Bartlett, D & Huang, M 2016, 'Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers: Is there a role?', Journal of Gastrointestinal Oncology, vol. 7, no. 1, pp. 10-17. https://doi.org/10.3978/j.issn.2078-6891.2015.103
Boisen, Michelle M. ; Richard, Scott D. ; Holtzman, Matthew P. ; Edwards, Robert P. ; Kelley, Joseph L. ; Choudry, Mohammad Haroon ; Bartlett, David ; Huang, Marilyn. / Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers : Is there a role?. In: Journal of Gastrointestinal Oncology. 2016 ; Vol. 7, No. 1. pp. 10-17.
@article{35a2096df9624043a63987417ea5f262,
title = "Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers: Is there a role?",
abstract = "Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is often used to treat gastrointestinal malignancies and is of interest in epithelial ovarian cancer (EOC) given the propensity for intraperitoneal spread. The role of HIPEC in the treatment of gynecologic malignancies is not well defined. We sought to describe clinical characteristics and outcomes of our patient population treated with HIPEC. Methods: IRB approval was obtained. Patients diagnosed with EOC and treated with HIPEC from January 2007 until December 2013 were identified using a prospectively maintained HIPEC database. Patient charts were abstracted to identify patient demographic information, treatment characteristics, and outcome data. Statistical analysis was descriptive. Results: Thirty-four patients were identified. Mean age at diagnosis was 56.5 years. The majority of cases (28, 82{\%}) were of serous histology. The indications for HIPEC administration were as follows: 9{\%} primary treatment, 41{\%} first recurrence, 26{\%} second recurrence, and 24{\%} consolidative therapy in the setting of primary or recurrent disease. The majority of patients (21, 62{\%}) received mitomycin C. The other drugs administered include cisplatin (10, 29{\%}), oxaliplatin (2, 6{\%}), and carboplatin (1, 3{\%}). Mean length of hospital stay was 9 days (range, 3-39 days). The rates of postoperative bacteremia and hematologic toxicity were 6{\%} and 54{\%}, respectively. Seven (21{\%}) patients developed transient renal dysfunction, and this was seen almost exclusively in the patients who received cisplatin. One (3{\%}) additional patient had renal dysfunction that persisted longer than 30 days post-operative but did not go on to require dialysis. There were no perioperative deaths in this cohort. Eleven (32{\%}) patients received additional chemotherapy following HIPEC administration. At a median follow-up of 20 months (range, 3-87 months), eight patients are alive with disease, seven have no evidence of disease, 14 have died of their disease, and five patients have been lost to follow-up. Conclusions: This data supports a reasonable side effect profile of treatment of EOC with HIPEC. Prospective studies are needed to elucidate the optimal drug and patient population that would derive the most benefit from treatment with HIPEC.",
keywords = "Chemotherapy, Epithelial ovarian cancer (EOC), Intraperitoneal infusions",
author = "Boisen, {Michelle M.} and Richard, {Scott D.} and Holtzman, {Matthew P.} and Edwards, {Robert P.} and Kelley, {Joseph L.} and Choudry, {Mohammad Haroon} and David Bartlett and Marilyn Huang",
year = "2016",
doi = "10.3978/j.issn.2078-6891.2015.103",
language = "English (US)",
volume = "7",
pages = "10--17",
journal = "Journal of Gastrointestinal Oncology",
issn = "2078-6891",
publisher = "Pioneer Bioscience Publishing Company (PBPC)",
number = "1",

}

TY - JOUR

T1 - Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancers

T2 - Is there a role?

AU - Boisen, Michelle M.

AU - Richard, Scott D.

AU - Holtzman, Matthew P.

AU - Edwards, Robert P.

AU - Kelley, Joseph L.

AU - Choudry, Mohammad Haroon

AU - Bartlett, David

AU - Huang, Marilyn

PY - 2016

Y1 - 2016

N2 - Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is often used to treat gastrointestinal malignancies and is of interest in epithelial ovarian cancer (EOC) given the propensity for intraperitoneal spread. The role of HIPEC in the treatment of gynecologic malignancies is not well defined. We sought to describe clinical characteristics and outcomes of our patient population treated with HIPEC. Methods: IRB approval was obtained. Patients diagnosed with EOC and treated with HIPEC from January 2007 until December 2013 were identified using a prospectively maintained HIPEC database. Patient charts were abstracted to identify patient demographic information, treatment characteristics, and outcome data. Statistical analysis was descriptive. Results: Thirty-four patients were identified. Mean age at diagnosis was 56.5 years. The majority of cases (28, 82%) were of serous histology. The indications for HIPEC administration were as follows: 9% primary treatment, 41% first recurrence, 26% second recurrence, and 24% consolidative therapy in the setting of primary or recurrent disease. The majority of patients (21, 62%) received mitomycin C. The other drugs administered include cisplatin (10, 29%), oxaliplatin (2, 6%), and carboplatin (1, 3%). Mean length of hospital stay was 9 days (range, 3-39 days). The rates of postoperative bacteremia and hematologic toxicity were 6% and 54%, respectively. Seven (21%) patients developed transient renal dysfunction, and this was seen almost exclusively in the patients who received cisplatin. One (3%) additional patient had renal dysfunction that persisted longer than 30 days post-operative but did not go on to require dialysis. There were no perioperative deaths in this cohort. Eleven (32%) patients received additional chemotherapy following HIPEC administration. At a median follow-up of 20 months (range, 3-87 months), eight patients are alive with disease, seven have no evidence of disease, 14 have died of their disease, and five patients have been lost to follow-up. Conclusions: This data supports a reasonable side effect profile of treatment of EOC with HIPEC. Prospective studies are needed to elucidate the optimal drug and patient population that would derive the most benefit from treatment with HIPEC.

AB - Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) is often used to treat gastrointestinal malignancies and is of interest in epithelial ovarian cancer (EOC) given the propensity for intraperitoneal spread. The role of HIPEC in the treatment of gynecologic malignancies is not well defined. We sought to describe clinical characteristics and outcomes of our patient population treated with HIPEC. Methods: IRB approval was obtained. Patients diagnosed with EOC and treated with HIPEC from January 2007 until December 2013 were identified using a prospectively maintained HIPEC database. Patient charts were abstracted to identify patient demographic information, treatment characteristics, and outcome data. Statistical analysis was descriptive. Results: Thirty-four patients were identified. Mean age at diagnosis was 56.5 years. The majority of cases (28, 82%) were of serous histology. The indications for HIPEC administration were as follows: 9% primary treatment, 41% first recurrence, 26% second recurrence, and 24% consolidative therapy in the setting of primary or recurrent disease. The majority of patients (21, 62%) received mitomycin C. The other drugs administered include cisplatin (10, 29%), oxaliplatin (2, 6%), and carboplatin (1, 3%). Mean length of hospital stay was 9 days (range, 3-39 days). The rates of postoperative bacteremia and hematologic toxicity were 6% and 54%, respectively. Seven (21%) patients developed transient renal dysfunction, and this was seen almost exclusively in the patients who received cisplatin. One (3%) additional patient had renal dysfunction that persisted longer than 30 days post-operative but did not go on to require dialysis. There were no perioperative deaths in this cohort. Eleven (32%) patients received additional chemotherapy following HIPEC administration. At a median follow-up of 20 months (range, 3-87 months), eight patients are alive with disease, seven have no evidence of disease, 14 have died of their disease, and five patients have been lost to follow-up. Conclusions: This data supports a reasonable side effect profile of treatment of EOC with HIPEC. Prospective studies are needed to elucidate the optimal drug and patient population that would derive the most benefit from treatment with HIPEC.

KW - Chemotherapy

KW - Epithelial ovarian cancer (EOC)

KW - Intraperitoneal infusions

UR - http://www.scopus.com/inward/record.url?scp=84995804491&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995804491&partnerID=8YFLogxK

U2 - 10.3978/j.issn.2078-6891.2015.103

DO - 10.3978/j.issn.2078-6891.2015.103

M3 - Article

AN - SCOPUS:84995804491

VL - 7

SP - 10

EP - 17

JO - Journal of Gastrointestinal Oncology

JF - Journal of Gastrointestinal Oncology

SN - 2078-6891

IS - 1

ER -