J Gynecol Oncol.  2012 Apr;23(2):91-97. 10.3802/jgo.2012.23.2.91.

Intraoperative intraperitoneal chemotherapy with cisplatin in epithelial ovarian cancer

• Kim MJ
• Jung YW
• Seong SJ
• Yoon BS
• Kim ML
• Joo WD
• Song TJ

• KMID: 2177581
• DOI: http://doi.org/10.3802/jgo.2012.23.2.91

Abstract

OBJECTIVE
To assess retrospectively the feasibility of intraoperative intraperitoneal (IP) chemotherapy with cisplatin in epithelial ovarian cancer.
METHODS
IP chemotherapy during optimal staging surgery was performed in 10 patients who were diagnosed with primary epithelial ovarian cancers between April 2008 and February 2011. Cisplatin (70 mg/m2 in 1 L normal saline solution) was administered in the abdominal cavity for 24 hours postoperatively and then adjuvant chemotherapy was started 2-4 weeks after surgery. Perioperative toxicity of the combined treatment was evaluated until the initiation of postoperative adjuvant chemotherapy.
RESULTS
A total of 23 adverse events were observed in 9 of 10 patients (grade 1, 7; grade 2, 13; grade 3, 3; grade 4, 0). In descending order of frequency, adverse events affected the gastrointestinal system (n=14), hematologic system (n=6), pulmonary system (n=2), and genito-urinary system (n=1). The adverse events did not affect adjuvant systemic chemotherapy schedules. One patient experienced disease recurrence in the liver 16 months after surgery. The remaining 9 patients have been well controlled by chemotherapy and/or observation during the follow-up period of 4 to 39 months after surgery.
CONCLUSION
Intraoperative IP chemotherapy with cisplatin during surgical procedures is considered feasible for the treatment of primary epithelial ovarian cancer. Further studies, including long-term, prospective and comparative trials, are needed to validate the efficacy of this combined therapy.

Keyword

Adjuvant chemotherapy; Intraperitoneal; Morbidity; Ovarian neoplasms

MeSH Terms

Abdominal Cavity
Appointments and Schedules
Chemotherapy, Adjuvant
Cisplatin
Follow-Up Studies
Humans
Liver
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms
Recurrence
Retrospective Studies
Cisplatin
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms

Figure

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  Fig. 1 Incidence (%) of 23 grade (G) 1 to 3 adverse events in patients with primary epithelial ovarian cancer who underwent cytoreductive surgery followed by intraoperative intraperitoneal (IP) chemotherapy. Nine of 10 patients experienced more than one adverse event of which 87% were grade 1 or 2. AST/ALT, aspartate aminotransferase/alanine aminotransferase.

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