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Peritonectomy and hyperthermic intraperitoneal chemotherapy for advanced epithelial ovarian cancer: What gynaecological oncologists really think
Author(s) -
Farrell Rhonda
Publication year - 2019
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/ajo.12972
Subject(s) - hyperthermic intraperitoneal chemotherapy , medicine , ovarian cancer , general surgery , cancer , surgery , oncology , cytoreductive surgery
Background Peritonectomy and hyperthermic intraperitoneal chemotherapy ( HIPEC ) is used in specialised units outside of gynaecological cancer centres in Australia and New Zealand to treat advanced epithelial ovarian cancer ( AEOC ). There is significant equipoise toward this treatment by gynaecological oncologists ( CGO s). Aims To determine the attitudes and preferences of CGO s toward peritonectomy and HIPEC for the treatment of AEOC . Materials and Methods A questionnaire was sent to all 53 CGO s in Australia and New Zealand asking their opinions about peritonectomy and HIPEC for the treatment of AEOC . Data collected included surgeon demographics, individual surgical practices, and willingness of CGO s to refer patients for peritonectomy or HIPEC . Potential factors influencing this decision were investigated using χ 2 tests and logistic regression analysis. Results Response rate was 89%. While 68% of CGO s would refer a patient for peritonectomy, most cases would be recurrent tumour of borderline or mucinous histology. Only 13% would refer a case of primary stage 3 EOC , even if predicting they cannot completely resect the tumour. This was due to concerns around morbidity and mortality, and a preference for neoadjuvant chemotherapy. In regard to HIPEC , 61% of CGO s were unsure about its use, due to reported lack of evidence, and potential morbidity. CGO s of female gender were more likely to recommend peritonectomy and HIPEC . Conclusions CGO s would refer only selected cases of AEOC for peritonectomy or HIPEC , due to concerns around insufficient evidence, and potential morbidity. The results of large well‐conducted clinical trials will help determine the future of peritonectomy and HIPEC for the treatment of AEOC .