Abstract
Peritoneal metastases represent a therapeutic challenge in the treatment of ovarian cancer. Macroscopically complete surgical cytoreduction is decisive for the patient's prognosis. The surgical part of the treatment includes a parietal and visceral peritonectomy, often carried out as a multivisceral resection. Its combination with intraperitoneal hyperthermic chemotherapy (HIPEC) has been found ...
Abstract
Peritoneal metastases represent a therapeutic challenge in the treatment of ovarian cancer. Macroscopically complete surgical cytoreduction is decisive for the patient's prognosis. The surgical part of the treatment includes a parietal and visceral peritonectomy, often carried out as a multivisceral resection. Its combination with intraperitoneal hyperthermic chemotherapy (HIPEC) has been found to significantly improve the prognosis of selected patients with gastrointestinal malignancies and peritoneal carcinomatosis. in the last four years several reports have been published on the use of a similar treatment in women with ovarian cancer, and more than 300 patients with ovarian cancer and peritoneal carcinomatosis were treated using this multimodal combination. However, the patient collectives were rather small and inhomogeneous and not all of the patients were treated according to the same protocol. Nevertheless, the technical feasibility of this method with low mortality and acceptable morbidity rates was demonstrated for patients treated in different centers. Intraoperative HIPEC enriches the presented concept but does not replace systemic or long-term intraperitoneal chemotherapy.,. Prospective, randomized phase III trials need to be designed, in order to define the exact role of HIPEC for this treatment concept. A protocol, combining proposals of the German Society of Visceral Surgery/Surgical Oncology Group and the Gynecology Oncology Group, would be therefore helpful.
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