A second chance for the second look: Feasibility of laparoscopic HIPEC at the conclusion of upfront treatment for epithelial ovarian cancer.

OBJECTIVE

To evaluate the feasibility, safety, and quality of life (QoL) in patients with advanced epithelial ovarian cancer (EOC) undergoing laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) as consolidation therapy following standard primary management.

METHODS

Patients with stage III-IVA EOC without clinical evidence of disease (physical exam, imaging, and CA125) and within 12 weeks of completing primary chemotherapy and surgery were enrolled. Patients underwent a second look laparoscopy (SLL) with HIPEC administration (carboplatin 800 mg/m2 for 90 min). Patients were followed for 6 months postoperatively and assessed for adverse events (AEs) and QoL scores using FACT-O questionnaires.

RESULTS

Ten consecutive patients were enrolled and completed SLL with carboplatin HIPEC (feasibility =100%). All patients experienced at least one grade 1 or 2 AE with most (91%) attributed to study treatment. Five patients (50%) experienced a grade 3 or 4 AE limited to myelosuppression (leukopenia, thrombocytopenia, and anemia). All AEs resolved within 6 weeks of the study intervention, and there were no study related deaths. Perioperative outcomes were favorable with no conversions to laparotomy, no blood transfusions, and no ICU admissions. QoL scores also improved from baseline (123) when assessed at the 3 (137)- and 6-month (137) postoperative time points.

CONCLUSION

Our study showed consolidation laparoscopic HIPEC to be feasible, safe, and well tolerated in this patient population. The most common AEs were related to chemotherapy. In our study, laparoscopic HIPEC did not adversely affect patient-reported QoL scores. This investigational approach may represent another way to offer patients HIPEC during upfront treatment of advanced EOC.