Skip to main content
SpringerLink
Log in

Cytoreductive Surgery With or Without HIPEC in the Management of Peritoneal Dissemination from Rare Histological Subtypes of Ovarian Cancer — a Retrospective Study by INDEPSO

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

The aim of this study was to evaluate the potential role of optimal cytoreductive surgery with or without HIPEC in the management of peritoneal dissemination from rare histological subtypes of ovarian cancer and to report the prognostic factors affecting survival. In this retrospective multicentric study, all patients with diagnosis of locally advanced ca ovary with histology other than high-grade serous carcinoma and those having undergone cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy for the same were included. Factors affecting survival were evaluated in addition to studying the clinicopathological features. In the period from January 2013 to December 2021, 101 consecutive patients of ovarian cancer with rare histology underwent cytoreductive surgery with or without HIPEC. The median OS was not reached (NR), and the median PFS was 60 months. On evaluation of factors affecting overall survival (OS) and progression-free survival (PFS), PCI > 15 was associated with not only a decreased PFS (p = 0.019) but also a decreased OS (P = 0.019) on univariate and multivariate analysis. With respect to histology, the best OS and PFS were seen with granulosa cell tumor, mucinous tumors for which median OS and median PFS were NR respectively. Cytoreductive surgery can be performed with an acceptable morbidity in patients with peritoneal dissemination from ovarian tumors of rare histology. The role of HIPEC and impact of other prognostic factors on the treatment and survival outcome need further evaluation in larger series of patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. McCluggage W. Glenn (2011) Morphological subtypes of ovarian carcinoma: a review with emphasis on new developments and pathogenesis. Pathology 43(5) :4220–432

  2. Kurman, RJ. ShihIe-Ming (2016) The dualistic model of ovarian carcinogenesis: revisited, revised, and expanded. Am J Pathol 186(4):733–747

  3. Shimada M, Kigawa J, Ohishi Y et al. (2009) Clinicopathological characteristics of mucinous adenocarcinoma of the ovary. Gynecol Oncol 113(3):331–334

  4. Morice P, Gouy S, Leary A et al (2019) N Engl J Med 380(13):1256–1266

    Article  CAS  PubMed  Google Scholar 

  5. Van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, et al. (2018) Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 378(3):230–40

  6. Di Giorgio A, Naticchioni E, Biacchi D, Sibio S, Accarpio F, Rocco M et al (2008) Cytoreductive surgery (peritonectomy procedures) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of diffuse peritoneal carcinomatosis from ovarian cancer. Cancer 113(2):315–325

    Article  PubMed  Google Scholar 

  7. Helm CW (2009) The role of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer. Oncologist 14(7):683–694

    Article  CAS  PubMed  Google Scholar 

  8. Tempfer CB, Solass W, Dogan A, Hefler LA, Reymond MA (2016) Hyperthermic intraperitoneal chemotherapy for women with granulosa cell tumors of the ovary: a systematic review of the literature. Pleura Peritoneum 1(1):15–22

    Article  PubMed  PubMed Central  Google Scholar 

  9. Mercier F, Bakrin N, Bartlett DL, Goere D, Quenet F, Dumont F et al (2018) Peritoneal carcinomatosis of rare ovarian origin treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a multi-institutional cohort from PSOGI and BIG-RENAPE. Ann Surg Oncol 25(6):1668–1675

    Article  PubMed  Google Scholar 

  10. Sugarbaker PH (1995) Peritonectomy procedures. Ann Surg 221(1):29–42

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Villeneuve L, Thivolet A, Bakrin N, Mohamed F, Isaac S, Valette PJ, et al. (2016) A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol 42(6):877–82

  12. United States Department of Public Health and Human Services, NIH, NCI: Common Toxicity Criteria for Adverse Events (CTCAE). National Cancer Institute, June 2010. http://evs.nci.nih.gov/ftp1/CTCAE_Vers._4.03_2010-06-14;_QuickReference_5x7.pdf

  13. van Meurs HS, Buist MR, Westermann AM, Sonke GS, Kenter GG, van der Velden J (2014) Effectiveness of chemotherapy in measurable granulosa cell tumors: a retrospective study and review of literature. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc 24(3):496–505

    Article  Google Scholar 

  14. Bristow RE, Chi DS (2006) Platinum-based neoadjuvant chemotherapy and interval surgical cytoreduction for advanced ovarian cancer: a meta-analysis. Gynecol Oncol 103(3):1070–1076

    Article  CAS  PubMed  Google Scholar 

  15. Bristow RE, Tomacruz RS, Armstrong AK et al (2002) Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 20(5):1248–1259

    Article  PubMed  Google Scholar 

  16. Chua TC, Moran B, Sugarbaker P et al (2012) Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. J Clin Oncol 30(20):2449–2456

    Article  PubMed  Google Scholar 

  17. El Halabi H, Gushchin V, Francis J et al (2012) The role of cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) in patients with high-grade appendiceal carcinoma and extensive peritoneal carcinomatosis. Ann Surg Oncol 19(1):110–114

    Article  PubMed  Google Scholar 

  18. Davis M, Rauh-Hain JA, Andrade C et al (2014) Comparison of clinical outcomes of patients with clear cell and endometrioid ovarian cancer associated with endometriosis to papillary serous carcinoma of the ovary. Gynecol Oncol 132:760–766

    Article  PubMed  Google Scholar 

  19. Lee YY et al (2011) Prognosis of ovarian clear cell carcinoma compared to other histological subtypes: a meta-analysis. GynecolOncol 122(3):541–547

    Google Scholar 

  20. Bamias A, Psaltopoulou T, Sotiropoulou M et al (2010) Mucinous but not clear cell histology is associated with inferior survival in patients with advanced stage ovarian carcinoma treated with platinum-paclitaxel chemotherapy. Cancer 116:1462–1468

    Article  PubMed  Google Scholar 

  21. Schiavone MB, Herzog TJ, Lewin SN et al (2011) Natural history and outcome of mucinous carcinoma of the ovary. Am J Obstet Gynecol 205(480):e1-8

    Google Scholar 

  22. Pectasides D, Fountzilas G, Aravantinos G et al (2005) Advanced stage mucinous epithelial ovarian cancer: the Hellenic cooperative oncology group experience. Gynecol Oncol 97:436–441

    Article  PubMed  Google Scholar 

  23. Bakrin N, Bereder JM, Decullier E, Classe JM et al (2013) Peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients. Eur J Surg Oncol 39(12):1435–1443

    Article  CAS  PubMed  Google Scholar 

  24. Seagle BL, Ann P, Butler S, Shahabi S (2017) Ovarian granulosa cell tumor: a National Cancer Database study. Gynecol Oncol 146(2):285–291

    Article  PubMed  Google Scholar 

  25. Chan JK, Zhang M, Kaleb V et al (2005) Prognostic factors responsible for survival in sex cord stromal tumor of the ovary: a multivariate analysis. Gynecol Oncol 96:204–209

    Article  PubMed  Google Scholar 

  26. Schlumbrecht P, Sun C, Wong K et al (2011) Clinicodemographic factors influencing outcomes in patients with low-grade serous ovarian carcinoma. Cancer 117(16):3741–3749

    Article  PubMed  Google Scholar 

  27. Chen M, Jin Y, Bi Y et al (2014) A survival analysis comparing women with ovarian low-grade serous carcinoma to those with high-grade histology. Onco Targets Ther 7:1891–1899

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Jehangir Hospital, 32, Sassoon Road, Pune, Maharashtra, India

    Snita Sinukumar

  2. Department of Surgical Oncology, MVR, Cancer Center and Research Institute, Calicut, Kerala, India

    Snita Sinukumar, Dileep Damodaran & Syam Vikram

  3. Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, Delhi, India

    Mukurdipi Ray

  4. Department of Surgical Oncology, Thangam Cancer Centre, Namakkal, Tamil Nadu, India

    Aruna Prabhu

  5. Department of Surgical Oncology, HCG Cancer Center, Mumbai, Maharashtra, India

    Ninad Katdare

  6. Department of Surgical Oncology, Zydus Hospital, Ahmedabad, Gujarat, India

    Sakina Shaikh, Ankita Patel & Aditi Bhatt

Authors
  1. Snita Sinukumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dileep Damodaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mukurdipi Ray
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aruna Prabhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ninad Katdare
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Syam Vikram
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sakina Shaikh
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ankita Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Aditi Bhatt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Snita Sinukumar.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 87 KB)

Supplementary file2 (DOCX 14 KB)

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sinukumar, S., Damodaran, D., Ray, M. et al. Cytoreductive Surgery With or Without HIPEC in the Management of Peritoneal Dissemination from Rare Histological Subtypes of Ovarian Cancer — a Retrospective Study by INDEPSO. Indian J Surg Oncol 14 (Suppl 1), 74–81 (2023). https://doi.org/10.1007/s13193-022-01640-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-022-01640-5

Keywords

Search

Navigation