5th International Conference on Gynecology and Obstetrics

Will be updated soon

Key messages:

What is already known on this topic: Worldwide at present ovarian cancer patients are being treated by CRS (cytoreductive surgery) and one cycle of intraoperative HIPEC (hyperthermic intraperitoneal chemotherapy). At the end of the procedure after about 120 minutes, the chemotherapy drugs are removed from the abdominal cavity before abdominal closure.

What this study adds: This study shows the possibility of treatment of ovarian cancer patients by CRS and multiple (up to 6) cycles of HIPEC at intervals of 3-4 weeks and at the end of the procedure the chemotherapy fluid was not sucked back from peritoneal cavity, so that the patients get the maximum benefit of synergistic action of hyperthermia & intraperitoneal chemotherapy targeting remaining cancer cells.

How this study may affect research, practice or policy:

1. In this study HIPEC is done by using Veress needle and IV Fluid warmer to treat patients. This will simplify the procedure and be highly cost effective with enormous reduction in the cost of treatment.

2. Secondly in this procedure chemotherapy drugs are not sucked out giving maximum chance for drugs to act on cancer cells.

3. HIPEC is given as postoperative procedure for six cycles after CRS [cytoreductive surgery] giving maximum chance of better patient outcome.

Introduction: Ovarian cancer is treated by CRS [cytoreductive surgery] and one cycle of intraoperative HIPEC (Hyperthermic Intraperitoneal Chemotherapy) and postoperatively 3 to 5 cycles of IV (intravenous) chemotherapy. If it is possible to treat ovarian cancer patients with multiple [up to six] cycles of HIPEC it may improve patient outcome, potentially leading to long-term control of cancers that have spread to the peritoneum.

Methods: Thirty patients with primary and recurrent ovarian tumors were treated with 146 cycles of HIPEC. Intraperitoneal instillation of chemotherapeutic drugs was done using Veress needle and temperature was maintained at 40°-41°C by IV Fluid warmer devices, like Hotline IV Fluid warmer. Patients received intraperitoneal cisplatin,100mg/m 2 and intravenous paclitaxel, 175mg/m2 on the same day for cycles 1, 3, and 5. For cycles 2,4, and 6, patients received intraperitoneal paclitaxel and intravenous carboplatin AUC 5. This treatment was continued for 6 cycles at intervals of 4 weeks.

Results: Out of 30 patients, 20 (66.6%) completed six cycles of HIPEC. Procedure related complications like pain in the abdomen, puncture site pain and cellulitis were managed conservatively. None had severe complications.

Conclusion: Our study shows HIPEC using Veress needle and IV Fluid warmer is a simple, and cost-effective procedure. Patients with intraabdominal malignancies can be treated by multiple cycles of heated chemotherapy and leaving the chemotherapy drug in the abdomen for increased action of chemotherapy drug. Six cycles of HIPEC can be administered at intervals of 4 weeks with fewer and treatable complications.