ABSTRACT
OBJECTIVE: Evaluation of the combined effect of secondary cytoreduction and continuous intraoperative intraperitoneal hyperthermic chemoperfusion (CIIPHCP), in the treatment of recurrent ovarian cancer, in a phase II clinical study. MATERIAL AND METHODS: Twenty consecutive, heavily pre-treated patients with recurrent epithelial ovarian cancer, were treated with a combination of cytoreductive surgery and CIIPHCP. All patients had extended peritoneal carcinomatosis. In 14 out of the 20 pts (70 %) the recurrence occurred during chemotherapy or within 6 months after the end of the chemotherapy. Thirteen pts (65 %) had preoperatively malignant ascites, whereas the remaining seven pts (35 %) had positive peritoneal cytology washings. RESULTS: No complications emerged during operation and CIIPHCP. Median ascites-free period after CIIPHCP was 21 months (range 3-109). Median survival time for patients with residual disease less than 1.5 cm was 29.0 months, whereas for patients with residual disease equal or greater than 1.5 cm, the median survival time was 7.0 months. This difference was statistically significant (P < 0.05). CONCLUSIONS: The survival data of our patients and the disappearance of the malignant ascites postoperatively suggest that continuous intraoperative intraperitoneal hyperthermic chemoperfusion is an effective treatment option for patients with recurrent ovarian cancer.
Subject(s)
Hyperthermia, Induced , Ovarian Neoplasms/surgery , Ovarian Neoplasms/therapy , Disease-Free Survival , Female , Humans , Hyperthermia, Induced/adverse effects , Intraoperative Care/methods , Intraoperative Period , Leukocyte Count , Ovarian Neoplasms/mortality , Perfusion , Recurrence , Survival Analysis , Time Factors , Urea/bloodABSTRACT
Female rats were infected with E. coli 0.25 by intravesical instillation. After 4 weeks, significantly higher bacterial counts (bladder puncture and renal homogenates) were found in estradiol treated rats (0.5 mg/kg/week) than in solvent controls, but the proportion of antibody-coated bacteria was significantly (P less than 0.01) lower in bladder urine and renal homogenates. There was no influence of estrogens on renal histology or ureteral width. The results are compatible with an effect of estrogens on local immune response in the urinary tract.
