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2 results

  • Debate 15B - Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?

  • from Section III - Ovarian Cancer
  • Edited by Dennis S. Chi, Memorial Sloan-Kettering Cancer Center, New York, Nisha Lakhi, Richmond University Medical Center, Staten Island, Nicoletta Colombo, University of Milan-Bicocca
  • Book:
    50 Big Debates in Gynecologic Oncology
    Published online:
    20 July 2023
    Print publication:
    03 August 2023, pp 85-87

  • Summary

    Intraperitoneal (IP) chemotherapy, the delivery of unheated chemotherapy into the peritoneal cavity through a catheter connected to an implanted port, was once a strongly recommended, though controversial, treatment for women with advanced ovarian cancer after optimal cytoreductive surgery. Historically, direct drug delivery to the IP cavity and improved pharmacokinetics yielded improved progression-free and overall survival outcomes. However, the improved disease control and survival came at the cost of significantly increased toxicity, worse quality of life, and added expense. The most recent randomized clinical trial of IP therapy identified a less toxic regimen but failed to demonstrate any survival benefit. The negative results of this study, taken in the setting of more recent advances in biologic therapies, illustrate that in the modern therapeutic landscape for ovarian cancer there is no role for IP chemotherapy. IP therapy is too toxic, too expensive, and historical IP therapy survival outcomes are no longer relevant.

  • 9 - Ovarian cancer standards of care

  • Edited by Nigel Acheson, David Luesley
  • Book:
    Gynaecological Oncology for the MRCOG and Beyond
    Published online:
    05 August 2014
    Print publication:
    01 January 2011, pp 115-144

  • Summary

    Ovarian cancer is the fourth most common cause of cancer deaths in women and the leading cause of gynaecological cancer death in Europe with a lifetime prevalence in the developed world of 1-2%. Primary ovarian tumours are a heterogeneous group, which includes epithelial tumours, sex-cord stromal and germ-cell tumours. There are a number of indications for surgery for ovarian carcinoma: establishment of diagnosis, accurate staging, primary cytoreduction, interval and secondary cytoreduction, and palliative and salvage surgery. Modest improvement in progression-free survival in the lymphadenectomy arm was offset by increased morbidity. Although surgery is usually the primary treatment, ovarian cancer is a chemosensitive disease and chemotherapy has been shown to improve prognosis in advanced disease. Treatment for relapsed disease is usually regarded as a palliative measure in women with symptomatic recurrent tumours. Radiotherapy is mainly used as palliative treatment to reduce pain and, occasionally, to control bleeding.