Peritoneal Carcinomatosis from Ovarian Cancer – Current Clinical Impact of Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy

Czech version

Authors: Dušna Klos ¹; Juraj Riško ¹; Jan Hanuliak ¹; Čestmír Neoral ¹; Radovan Pilka ²; Petr Dzvinčuk ²; Radmila Lemstrová ³; Bohuslav Melichar ³; Beatrice Duchoňová-Mohelníková ³
Authors‘ workplace: I. chirurgická klinika LF UP a FN Olomouc 2 Porodnicko-gynekologická klinika LF UP a FN Olomouc 3 Onkologická klinika LF UP a FN Olomouc ¹
Published in: Klin Onkol 2019; 32(5): 349-352
Category: Review
doi: https://doi.org/10.14735/amko2019349

Overview

Epithelial ovarian cancer is one of the most common causes of cancer-related death in women. More than half of patients are diagnosed at an advanced stage, usually due to locoregional spread of peritoneal carcinomatosis. A combination of systemic chemotherapy and cytoreductive surgery has been the standard treatment since the mid-1990s. However, conventional chemotherapy is poorly delivered to the peritoneum due to the plasma-peritoneal barrier. Intraperitoneal chemotherapy can improve survival by eliminating residual microscopic disease. A combination of hyperthermic intravenous and intraperitoneal chemotherapy may reduce plasma toxicity and increase therapeutic effectiveness. Several experts are investigating the effectiveness of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for both primary and recurrent ovarian cancer worldwide. Recent randomized studies indicate that this method prolongs overall patient survival and the disease-free interval. This approach is not yet part of standard guidelines and is the subject of several other clinical trials. However, indications should be considered in women with significant residual disease after neoadjuvant chemotherapy because these patients can benefit from comprehensive surgical resection in combination with hyperthermic intraperitoneal chemotherapy to prevent locoregional relapses.

Keywords:

cytoreductive surgery – hyperthermic intraperitoneal chemotherapy – ovarian cancer

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