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Intraperitoneal chemotherapy for recurrent epithelial ovarian cancer is feasible with high completion rates, low complications, and acceptable patient outcomes
Journal article   Open access   Peer reviewed

Intraperitoneal chemotherapy for recurrent epithelial ovarian cancer is feasible with high completion rates, low complications, and acceptable patient outcomes

Malgorzata E Skaznik-Wikiel, Jamie L Lesnock, William C McBee, Sushil Beriwal, Kristin K Zorn, Scott D Richard, Thomas C Krivak and Robert P Edwards
International journal of gynecological cancer, v 22(2), pp 232-237
Feb 2012
DOI: https://doi.org/10.1097/IGC.0b013e318234f833
PMID: 22080886
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1097/igc.0b013e318234f833View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Adenocarcinoma, Papillary - drug therapy Adenocarcinoma, Papillary - mortality Adenocarcinoma, Papillary - pathology Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - adverse effects Carcinoma, Ovarian Epithelial Disease-Free Survival Drug Resistance, Neoplasm Female Humans Infusions, Parenteral Middle Aged Neoplasm Recurrence, Local - drug therapy Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Staging Neoplasms, Glandular and Epithelial - drug therapy Neoplasms, Glandular and Epithelial - mortality Neoplasms, Glandular and Epithelial - pathology Ovarian Neoplasms - drug therapy Ovarian Neoplasms - mortality Ovarian Neoplasms - pathology Paclitaxel Pennsylvania Retrospective Studies Survival Analysis Treatment Outcome Registries
Three large randomized clinical trials have shown a survival benefit for patients treated with intraperitoneal (IP) compared with intravenous chemotherapy for advanced stage epithelial ovarian cancer (EOC). However, the use of IP chemotherapy in recurrent EOC is controversial. The purpose of this study was to determine outcomes, completion rates, and frequency of complications in patients with platinum-sensitive recurrent EOC treated with IP chemotherapy. A retrospective, single-institution analysis of women who received IP chemotherapy for recurrent EOC from January 2003 to April 2010 was conducted. Study patients were identified from the Tumor Registry and office records. Demographic factors, stage, histology, surgical findings, cytoreduction status, and subsequent therapies were abstracted. Progression-free (PFS) and overall survival (OS) were estimated by Kaplan-Meier methods. Fifty-six women who received IP chemotherapy for their first EOC recurrence were identified. The mean age of patients was 56.7 years (range, 40-79 y). Fifty-five patients (98.3%) had previously completed at least 6 cycles of intravenous chemotherapy. Of all patients, 87.5% were initially diagnosed with advanced stage disease (stage IIA-IV). All patients underwent secondary cytoreduction at the time of IP port placement. Moreover, 67.9% of patients were considered optimally cytoreduced (<1 cm residual disease) at the end of the secondary debulking surgery. Forty-two patients (75%) were able to successfully complete at least 6 cycles of IP chemotherapy. Reasons for noncompletion were disease progression, allergic reaction, renal failure, pain, severe nausea and vomiting, death, and patient refusal. Six patients (10.7%) developed port complications including pain around port site, port malfunction, and port erosion into small bowel. Median PFS since the initiation of IP chemotherapy was 10.5 months (95% confidence interval, 7.5-16.4 months) and median OS was 51 months (95% confidence interval, 40.8-61.1 months). Intraperitoneal chemotherapy is a feasible option for patients with recurrent EOC, with high completion rates, low frequency of complications, and acceptable PFS and OS.

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14 citations in Web of Science
12 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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Web of Science research areas
Obstetrics & Gynecology
Oncology
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