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Annals of Oncology Advance Access originally published online on May 11, 2007
Annals of Oncology 2007 18(12):1943-1950; doi:10.1093/annonc/mdm137
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© 2007 European Society for Medical Oncology

reviews

Systematic review of cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis in primary and recurrent ovarian cancer

L. Bijelic1, A. Jonson2 and P. H. Sugarbaker1,*

1 Peritoneal Surface Malignancy Program, Washington Cancer Institute, Washington DC
2 Department of Women's Services, Washington Hospital Center, Washington DC, USA

* Correspondence to: Dr P. H. Sugarbaker, Peritoneal Surface Malignancy Program, 106 Irving Street, NW, Suite 3900N, Washington DC, USA 20010. Tel: +1-202-877-3908; Fax: +1-202-877-8602; E-mail: paul.sugarbaker{at}medstar.net

The aim of this systematic review is to critically evaluate cytoreductive surgery combined with heated intraoperative intraperitoneal chemotherapy in the treatment of ovarian cancer. A systematic review of all manuscripts published in the English literature that met predetermined inclusion criteria was carried out. Data concerning cytoreductive surgery, method and agents for administration of heated intraoperative intraperitoneal chemotherapy, morbidity, mortality, hospital stay and survival were extracted, critically reviewed and tabulated. Fourteen studies were analyzed. A wide variety of drug doses, methods of intraperitoneal chemotherapy administration and volume of chemotherapy solution were used. Seven studies showed that patients with complete cytoreduction had the greatest benefit. The median overall survival for primary and recurrent disease ranged from 22 to 54 months and the median disease-free survival from 10 to 26 months. The rates of significant morbidity associated with this combined treatment were low, ranging from 5% to 36%. The median mortality was 3% (range 0%–10%). Cytoreductive surgery combined with heated intraoperative intraperitoneal chemotherapy is a treatment option for patients with ovarian cancer that is worthy of further investigation. Selection criteria for patients most likely to benefit need to be defined.

Key words: cytoreductive surgery, heat, hyperthermia, intraperitoneal chemotherapy, ovarian cancer

Received for publication January 8, 2007. Revision received March 15, 2007. Accepted for publication March 22, 2007.


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