Geburtshilfe Frauenheilkd 2013; 73(3): 221-223
DOI: 10.1055/s-0032-1328320
Statement
Georg Thieme Verlag KG Stuttgart · New York

Statement by the Kommission OVAR of the AGO Study Group on the Use of HIPEC (Hyperthermic Intraperitoneal Chemotherapy) to Treat Primary and Recurrent Ovarian Cancer

Stellungsnahme der AGO Kommission OVAR zum Einsatz der HIPEC (Hypertherme intraperitoneale Chemotherapie) beim primären und rezidivierten Ovarialkarzinom
P. Harter
1   Kliniken-Essen-Mitte, Essen
,
S. Mahner
2   Universitätsklinikum Hamburg-Eppendorf, Hamburg
,
F. Hilpert
3   Universitätsklinikum Schleswig Holstein, Campus Kiel, Kiel
,
I. Runnebaum
4   Universitätsklinikum Jena, Jena
,
O. Ortmann
5   Universitätsklinikum Regensburg, Regensburg
,
A. Mustea
6   Universitätsklinikum Greifswald, Greifswald
,
J. Sehouli
7   Universitätsmedizin Berlin Charite, Berlin
,
A. du Bois
1   Kliniken-Essen-Mitte, Essen
,
U. Wagner
8   Universitätsklinikum Marburg, Marburg
,
for the Kommission Ovar of the Arbeitsgemeinschaft Gynäkologische Onkologie › Author Affiliations
Further Information

Publication History

Publication Date:
04 April 2013 (online)

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Abstract

HIPEC is offered to patients with ovarian, fallopian tube or primary peritoneal cancer at some hospitals. Altogether, there is still no evidence that HIPEC leads to an improvement of prognosis in any gynecologic tumor, neither in primary therapy nor in treatment of relapse. The available data indicate an increased complication rate which might negatively impact the benefit-risk balance of this procedure. In addition, standard treatment with proven efficacy might be withheld due to application of unproven methods. The use of HIPEC outside of well designed, prospective and controlled clinical trials is therefore disregarded.

Zusammenfassung

Die HIPEC wird Patientinnen mit einer durch ein Ovarial-, Tuben-, oder primären Peritonealkarzinom bedingten Peritonealkarzinose an einigen Kliniken angeboten. Insgesamt gibt es jedoch keinen Nachweis, dass bei einem gynäkologischen Tumor durch Einsatz der HIPEC weder in der Primär- noch in der Rezidivsituation eine Verbesserung der Prognose erreicht werden kann. Aufgrund der derzeitigen Datenlage kann durch eine erhöhte Komplikationsrate auch eine Verschlechterung der Prognose nicht ausgeschlossen werden, insbesondere wenn hierdurch den Patientinnen eine erwiesenermaßen wirksame Standardtherapie vorenthalten wird. Daher wird von einer Durchführung der HIPEC außerhalb von prospektiven kontrollierten Studien abgeraten.

Key words

ovarian cancer - statement - HIPEC - AGO

Schlüsselwörter

Ovarialkarzinom - Empfehlung - HIPEC - AGO

Supporting Information

 

  • References

  • 1 Griffiths CT, Fuller AF. Intensive surgical and chemotherapeutic management of advanced ovarian cancer. Surg Clin North Am 1978; 58: 131-142
    PubMedGoogle Scholar
  • 2 Harter P, Muallem ZM, Buhrmann C et al. Impact of a structured quality management program on surgical outcome in primary advanced ovarian cancer. Gynecol Oncol 2011; 121: 615-619
    CrossrefPubMedGoogle Scholar
  • 3 Bristow RE, Tomacruz RS, Armstrong DK et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002; 20: 1248-1259
    CrossrefPubMedGoogle Scholar
  • 4 du Bois A, Reuss A, Pujade-Lauraine E et al. Role of surgical outcome as prognostic factor in advanced epithelial ovarian cancer: a combined exploratory analysis of 3 prospectively randomized phase 3 multicenter trials: by the Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom (AGO-OVAR) and the Groupe dʼInvestigateurs Nationaux Pour les Etudes des Cancers de lʼOvaire (GINECO). Cancer 2009; 115: 1234-1244
    CrossrefPubMedGoogle Scholar
  • 5 Stuart GC, Kitchener H, Bacon M et al. 2010 Gynecologic Cancer InterGroup (GCIG) consensus statement on clinical trials in ovarian cancer: report from the Fourth Ovarian Cancer Consensus Conference. Int J Gynecol Cancer 2011; 21: 750-755
    CrossrefPubMedGoogle Scholar
  • 6 Hahn GM. Potential for therapy of drugs and hyperthermia. Canc Res 1979; 39: 2264-2268
    PubMedGoogle Scholar
  • 7 Meyn RE, Corry PM, Fletcher SE et al. Thermal enhancement of DNA damage in mammalian cells treated with cis-diamminedichloroplatinum(II). Cancer Res 1980; 40: 1136-1139
    PubMedGoogle Scholar
  • 8 Alberts DS, Peng YM, Chen HS et al. Therapeutic synergism of hyperthermia-cis-platinum in a mouse tumor model. J Nat Cancer Inst 1980; 65: 455-461
    PubMedGoogle Scholar
  • 9 Los G, van Vugt M, Pinedo HM. Response of peritoneal solid tumours after intraperitoneal chemohyperthermia treatment with cisplatin or carboplatin. Br J Cancer 1994; 69: 235-241
    CrossrefPubMedGoogle Scholar
  • 10 Akaboshi M, Tanaka Y, Kawai K et al. Effect of hyperthermia on the number of platinum atoms binding to DNA of HeLa cells treated with 195 mPt-radiolabelled cis-diaminedichloroplatinum(II). Int J Radiat Biol 1994; 66: 215-220
    CrossrefPubMedGoogle Scholar
  • 11 Herman TS, Teicher BA, Cathcart KN et al. Effect of hyperthermia on cis-diamminedichloroplatinum(II) (rhodamine 123)2[tetrachloroplatinum(II)] in a human squamous cell carcinoma line and a cis-diamminedichloroplatinum(II)-resistant subline. Cancer Res 1988; 48: 5101-5105
    PubMedGoogle Scholar
  • 12 van de Vaart PJ, van der Vange N, Zoetmulder FA et al. Intraperitoneal cisplatin with regional hyperthermia in advanced ovarian cancer: pharmacokinetics and cisplatin-DNA adduct formation in patients and ovarian cancer cell lines. Eur J Cancer 1998; 34: 148-154
    CrossrefPubMedGoogle Scholar
  • 13 Verwaal VJ, van Ruth S, de Bree S et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliatve surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 2003; 21: 3737-3743
    CrossrefPubMedGoogle Scholar
  • 14 Verwaal VJ, Bruin S, Boot H et al. 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 2008; 15: 2426-2432
    CrossrefPubMedGoogle Scholar
  • 15 Yang XJ, Huang CQ, Suo T et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Ann Surg Oncol 2011; 18: 1575-1581
    CrossrefPubMedGoogle Scholar
  • 16 Yonemura Y, de Aretxabala X, Fujimura T et al. Intraoperative chemohyperthermic peritoneal perfusion as an adjuvant to gastric cancer: final results of a randomized controlled study. Hepatogastroenterology 2001; 48: 1776-1782
    PubMedGoogle Scholar
  • 17 Heiss MM, Murawa P, Koralewski P et al. The trifunctional antibody catumaxomab for the treatment of malignant ascites due to epithelial cancer: Results of a prospective randomized phase II/III trial. Int J Cancer 2010; 127: 2209-2221
    CrossrefPubMedGoogle Scholar
  • 18 S3 Leitlinie Magenkarzinom 13. 06. 2012; AWMF-Register-Nummer (032-009OL).
    PubMedGoogle Scholar
  • 19 Robert Koch-Institut und die Gesellschaft der epidemiologischen Krebsregister in Deutschland e. V. Hrsg. Krebs in Deutschland 2007/2008. 8. Ausgabe. Berlin: 2012. 8. 76-79
    Google Scholar
  • 20 Brand AH. Ovarian cancer debulking surgery: a survey of practice in Australia and New Zealand. Int J Gynecol Cancer 2011; 21: 230-235
    CrossrefPubMedGoogle Scholar
  • 21 Beutel B, Heitz F, Harter P et al. Was sind die Gründe für postoperativen Tumorrest beim fortgeschrittenen Ovarialkarzinom FIGO IIIB-IV[OC] bei OP in einem spezialisierten Zentrum. Arch Gynecol Obstet 2012; 286 (Suppl. 01) S113
    PubMedGoogle Scholar
  • 22 Heitz J, Harter P, Meier W et al. Chirurgische Komplettresektion versus medikamentöse Komplettremission bei fortgeschrittenem Ovarialkarzinom FIGO IIB-IV. Arch Gynecol Obstet 2012; 286 (Suppl. 01) S98
    PubMedGoogle Scholar
  • 23 Harter P, Hahmann M, Lueck HJ et al. Surgery for recurrent ovarian cancer: role of peritoneal carcinomatosis: exploratory analysis of the DESKTOP I Trial about risk factors, surgical implications, and prognostic value of peritoneal carcinomatosis. Ann Surg Oncol 2009; 16: 1324-1330
    CrossrefPubMedGoogle Scholar
  • 24 Fotopoulou C, Zang R, Gultekin M et al. Value of tertiary cytoreductive surgery in epithelial ovarian cancer: an international multicenter evaluation. Ann Surg Oncol 2012; Oct 2 [Epub ahead of print]
    PubMedGoogle Scholar
  • 25 Bijelic L, Jonson A, Sugarbaker PH. Systematic review of cytoreductive surgery and heated intraoperative intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis in primary and recurrent ovarian cancer. Ann Oncol 2007; 18: 1943-1950
    CrossrefPubMedGoogle Scholar
  • 26 Harter P, Heitz F, du Bois A. Surgery for relapsed ovarian cancer: when should it be offered?. Curr Oncol Rep 2012; 14: 539-543
    CrossrefPubMedGoogle Scholar
  • 27 Armstrong DK, Bundy B, Wenzel L et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 2006; 354: 34-43
    CrossrefPubMedGoogle Scholar
  • 28 Gore M, du Bois A, Vergote I. Intraperitoneal chemotherapy in ovarian cancer remains experimental. J Clin Oncol 2006; 24: 4528-4530
    CrossrefPubMedGoogle Scholar
  • 29 du Bois A, Schmalfeldt B, Meier W et al. für die Kommission Ovar der AGO, die AGO-Studiengruppe Ovarialkarzinom (AGO-OVAR) und die NOGGO. Ovarialkarzinom: Intraperitoneale Therapie ist nicht der neue Standard. Frauenarzt 2006; 47: 510-512
    PubMedGoogle Scholar