HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review

Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with interval debulking surgery (IDS) constitutes an adjunctive treatment strategy in advanced ovarian cancer (AOC). This approach is based on the concept of perfusing chemotherapy targeting directly the site of residual tumor af...

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Main Authors: Stefano Restaino, Jessica Mauro, Stefano Cianci, Alessandro Buda, Claudia Andreetta, Elena Poletto, Enrico Maria Pasqual, Alice Poli, Cosimo Vittorio Agrimi, Doriana Armenise, Alice Buzzelli, Domenico Caccamo, Lorenza Driul, Giuseppe Vizzielli
Format: Article
Language:English
Published: IMR Press 2022-06-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906143
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author Stefano Restaino
Jessica Mauro
Stefano Cianci
Alessandro Buda
Claudia Andreetta
Elena Poletto
Enrico Maria Pasqual
Alice Poli
Cosimo Vittorio Agrimi
Doriana Armenise
Alice Buzzelli
Domenico Caccamo
Lorenza Driul
Giuseppe Vizzielli
author_facet Stefano Restaino
Jessica Mauro
Stefano Cianci
Alessandro Buda
Claudia Andreetta
Elena Poletto
Enrico Maria Pasqual
Alice Poli
Cosimo Vittorio Agrimi
Doriana Armenise
Alice Buzzelli
Domenico Caccamo
Lorenza Driul
Giuseppe Vizzielli
author_sort Stefano Restaino
collection DOAJ
description Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with interval debulking surgery (IDS) constitutes an adjunctive treatment strategy in advanced ovarian cancer (AOC). This approach is based on the concept of perfusing chemotherapy targeting directly the site of residual tumor after optimal surgical debulking. It improves patients’ outcome in terms of overall survival (OS) and disease free survival (DFS). The correct selection of patients eligible for IDS + HIPEC is crucial: in particular, they must have shown a good response to neoadjuvant chemotherapy (NACT) and have a good performance status (PS). The application of HIPEC at the end of debulking does not seem to increase neither the rate of intra/postoperative complications nor the time of hospitalization. Clinical Cases: After approving an internal protocol for the application of HIPEC in our hospital, we have submitted four patients to IDS + HIPEC in the past 12 months. One of these patients underwent a minimally invasive procedure. No intra- or postoperative complications were observed. Results: All patients underwent IDS + HIPEC after being assessed as eligible and after showing a good response to NACT. In the course of IDS in all cases complete debulking was achieved. No patient developed intra- or postoperative complications. Conclusions: The addition of HIPEC to interval debulking surgery should be offered to all eligible patients, considering that the association of HIPEC to IDS seems to improve patients’ outcomes in terms of OS and DFS, without increasing post-operative morbidity .
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spelling doaj-art-efa8d3eb2e3a472aabcd2a3b43b9cd5c2025-08-20T03:48:36ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632022-06-0149614310.31083/j.ceog4906143S0390-6663(22)01822-XHIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature ReviewStefano Restaino0Jessica Mauro1Stefano Cianci2Alessandro Buda3Claudia Andreetta4Elena Poletto5Enrico Maria Pasqual6Alice Poli7Cosimo Vittorio Agrimi8Doriana Armenise9Alice Buzzelli10Domenico Caccamo11Lorenza Driul12Giuseppe Vizzielli13Clinic of Obstetrics and Gynecology, “Santa Maria della Misericordia'', University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyClinic of Obstetrics and Gynecology, “Santa Maria della Misericordia'', University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyDepartment of Human Pathology of Adult and Childhood “G. Barresi'', Unit of Gynecology and Obstetrics, University of Messina, 98122 Messina, ItalyDivision of Gynecologic Oncology, Michele e Pietro Ferrero Hospital, 12060 Verduno, ItalyDepartment of Oncology, ASUFC Udine University Hospital, 33100 Udine, ItalyDepartment of Oncology, ASUFC Udine University Hospital, 33100 Udine, ItalyDepartment of Medical Area, University of Udine, Santa Maria della Misericordia University Hospital Udine, 33100 Udine, ItalyClinic of Obstetrics and Gynecology, “Santa Maria della Misericordia'', University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyUniversity of Udine, Department of Medical Area (DAME), Medical School, 33100 Udine, ItalyUniversity of Udine, Department of Medical Area (DAME), Medical School, 33100 Udine, ItalyUniversity of Udine, Department of Medical Area (DAME), Medical School, 33100 Udine, ItalyUniversity of Udine, Department of Medical Area (DAME), Medical School, 33100 Udine, ItalyClinic of Obstetrics and Gynecology, “Santa Maria della Misericordia'', University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyClinic of Obstetrics and Gynecology, “Santa Maria della Misericordia'', University Hospital - Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyBackground: Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with interval debulking surgery (IDS) constitutes an adjunctive treatment strategy in advanced ovarian cancer (AOC). This approach is based on the concept of perfusing chemotherapy targeting directly the site of residual tumor after optimal surgical debulking. It improves patients’ outcome in terms of overall survival (OS) and disease free survival (DFS). The correct selection of patients eligible for IDS + HIPEC is crucial: in particular, they must have shown a good response to neoadjuvant chemotherapy (NACT) and have a good performance status (PS). The application of HIPEC at the end of debulking does not seem to increase neither the rate of intra/postoperative complications nor the time of hospitalization. Clinical Cases: After approving an internal protocol for the application of HIPEC in our hospital, we have submitted four patients to IDS + HIPEC in the past 12 months. One of these patients underwent a minimally invasive procedure. No intra- or postoperative complications were observed. Results: All patients underwent IDS + HIPEC after being assessed as eligible and after showing a good response to NACT. In the course of IDS in all cases complete debulking was achieved. No patient developed intra- or postoperative complications. Conclusions: The addition of HIPEC to interval debulking surgery should be offered to all eligible patients, considering that the association of HIPEC to IDS seems to improve patients’ outcomes in terms of OS and DFS, without increasing post-operative morbidity .https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906143advanced ovarian cancerhipecinterval debulking surgery
spellingShingle Stefano Restaino
Jessica Mauro
Stefano Cianci
Alessandro Buda
Claudia Andreetta
Elena Poletto
Enrico Maria Pasqual
Alice Poli
Cosimo Vittorio Agrimi
Doriana Armenise
Alice Buzzelli
Domenico Caccamo
Lorenza Driul
Giuseppe Vizzielli
HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
Clinical and Experimental Obstetrics & Gynecology
advanced ovarian cancer
hipec
interval debulking surgery
title HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
title_full HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
title_fullStr HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
title_full_unstemmed HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
title_short HIPEC after Interval Debulking Surgery as Best Clinical Practice in Ovarian Cancer Patients: Case Series and Literature Review
title_sort hipec after interval debulking surgery as best clinical practice in ovarian cancer patients case series and literature review
topic advanced ovarian cancer
hipec
interval debulking surgery
url https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906143
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