ABSTRACT
OBJECTIVE: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been recently reported with favorable oncological outcomes as treatment of advanced epithelial ovarian cancer (EOC). The aim of this study was to demonstrate the feasibility of CRS+HIPEC with cisplatin and paclitaxel for the treatment of advanced EOC. METHODS: This is a prospective observational study of 54 patients, from April 2007 to October 2013, with primary or recurrent peritoneal carcinomatosis due to EOC. The mean age was 54.51+/-9.34. Thirty patients (59%) had primary EOC, and 24 patients (41%) had recurrent disease. RESULTS: Mean peritoneal cancer index was 10.11 (range, 0 to 28), complete cytoreduction (CC0) was achieved for 47 patients (87%), CC1 for seven patients (13%). Patients with suboptimal cytoreduction (CC2 and CC3) were not included in the study. The mean stay in intensive care unit was 4.73+/-5.51 days and the mean hospitalization time was 24.0+/-10.03 days. We did not observe any intraoperative death. Seven patients (13%) required additional operations. Three patients (5.6%) died within 30 days from the procedure. Severe complications were seen in 19 patients (35.2%). During the follow-up period, disease recurred in 33 patients (61.1%); the median disease-free survival time was 12.46 months and the median overall survival time was 32.91 months. CONCLUSION: CRS+HIPEC with cisplatin and paclitaxel for advanced EOC is feasible with acceptable morbidity and mortality. Additional follow-up and further studies are needed to determine the effects of HIPEC on long term survival.
Subject(s)
Adult , Female , Humans , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cisplatin/administration & dosage , Combined Modality Therapy , Cytoreduction Surgical Procedures/adverse effects , Feasibility Studies , Hyperthermia, Induced/adverse effects , Infusions, Parenteral , Kaplan-Meier Estimate , Neoplasm Recurrence, Local/drug therapy , Ovarian Neoplasms/drug therapy , Paclitaxel/administration & dosage , Prospective Studies , Treatment OutcomeABSTRACT
Cistos quilosos e ascite quilosa sao entidades ja bem conhecidas na literatura medica. Este caso raro na pratica medica, tem valor emvirtude de acrescentar ao diagnostico diferencial de tumores retroperitoneais uma entidade relacionada com o trauma abdominal fechado, que muito mimetizou umaentidade neoplasica. Tal entidade so foi definitivamente afastada apos revermos o caso e tambem atraves de acompanhamento seriado do paciente, a longo prazo. Achamos que nossa denominacao de "pseudocisto" se justifica pelos achados cirurgicos, pela breve discussao que veremos no relato a seguir.