Peritonectomy and abdominal hyperthermic perfusion in ovarian cancer

Second-look procedures and interval surgery have failed to modify the prognosis of patients affected by ovarian cancer with residual disease at the end of primary treatment, even if the surgeon was able to perform an optimal secondary citoreduction. In order to improve these results, we began a feasibility study with extensive interval surgery, followed by intraoperative hyperthermic abdominal perfusion with cisplatin. We present our cxperience with five female patients, mean age 61 years, affected by ovarian cancer, who had residual disease at the end of primary therapy (surgery plus chemotherapy). We performed five combined peritonectomies (Sugarbaker classification). with optimal citoreduction, without any postoperative mortality and with two aspecific complications (one pneumonia and one wound leakage). Chemotherapic treatment was performed intraoperatively, perfusing the abdomen, via pump for extracorporeal circulation, with saline solution heated at 41°C and cisplatin (50mg/mq), for I hour. All patients had negative cytology on abdominal drainage and normalization of CaIZs values. Mean hospital stay was 10 days. Follow-up is short to evaluate long-term prognosis, but the technique has proved to be feasible without major morbidity and mortality and effective in eliminating residual disease