Hepato-gastroenterology · 2012
Laparoscopic HIPEC in the treatment of advanced ovarian cancer.
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Lygidakis Nikolaos J, Seretis Konstantinos
Аннотация
BACKGROUND/AIMS: HIPEC has been recently recommended as the 'new standard of care' for advanced ovarian cancer patients to treat residual disease, a recommendation based on the good results reported by many single institution studies. This study aims to elucidate whether cyto-reductive surgery for advanced stage IV ovarian cancer combined with laparoscopic HIPEC has any value in the management of advanced ovarian cancer.
METHODOLOGY: From January 2007 to October 2011, 31 patients with stage IV ovarian cancer were enrolled. The inclusion criteria were stage IV epithelial ovarian cancer, with no evidence of extra-abdominal metastasis, and without previous systemic chemotherapy. Patients were randomly divided into two groups, group A and group B, which consisted of 12 patients who received laparoscopic HIPEC in a neo-adjuvant setting, and 19 patients who received laparoscopic HIPEC in an adjuvant setting, respectively.
RESULTS: Overall response rate after Laparoscopic HIPEC (neo-adjuvant and adjuvant) was 100%. Macroscopic images recorded during initial laparoscopy and subsequent laparoscopies revealed a dramatic decrease in the size of the neoplastic deposits accompanied with a decrease in their absolute number.
DISCUSSION: The results of this study indicate that laparoscopic HIPEC preceding multi-organ radical surgery has been seen to be associated with optimal short and long-term results, and promising OS and DFS. They also demonstrate the therapeutical advantage of neo-adjuvant initial approach over adjuvant approach.
METHODOLOGY: From January 2007 to October 2011, 31 patients with stage IV ovarian cancer were enrolled. The inclusion criteria were stage IV epithelial ovarian cancer, with no evidence of extra-abdominal metastasis, and without previous systemic chemotherapy. Patients were randomly divided into two groups, group A and group B, which consisted of 12 patients who received laparoscopic HIPEC in a neo-adjuvant setting, and 19 patients who received laparoscopic HIPEC in an adjuvant setting, respectively.
RESULTS: Overall response rate after Laparoscopic HIPEC (neo-adjuvant and adjuvant) was 100%. Macroscopic images recorded during initial laparoscopy and subsequent laparoscopies revealed a dramatic decrease in the size of the neoplastic deposits accompanied with a decrease in their absolute number.
DISCUSSION: The results of this study indicate that laparoscopic HIPEC preceding multi-organ radical surgery has been seen to be associated with optimal short and long-term results, and promising OS and DFS. They also demonstrate the therapeutical advantage of neo-adjuvant initial approach over adjuvant approach.