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Multimodal oncosurgery approach to treat peritoneal carcinomatosis in a patient with occlusive ovarian carcinoma

  • B. Moldovan1,*,
  • F. Pescaru2
  • D. Pocreaţă1
  • P. Biriş3
  • A. Moldovan4
  • M.E. Căpîlna5

1General Surgery Department, "Sf.Constantin" Hospital, Braşov, Romania

2Oncology Department, "Sf.Constantin" Hospital, Braşov, Romania

3"Regina Maria" Diagnostic and Imagistics Centre, Braşov, Romania

4Department of Infectious Diseases, "Sf.Constantin" Hospital, Braşov, Romania

51st Obstetrics and Gynaecology Clinic, Targu-Mureş, Romania

DOI: 10.12892/ejgo2806.2016 Vol.37,Issue 2,April 2016 pp.251-253

Published: 10 April 2016

*Corresponding Author(s): B. Moldovan E-mail: bogdan.moldovan@spitalulsfconstantin.ro

Abstract

Background: This paper aims to present a "pattern" of oncosurgery solution in a case generally considered unrecoverable: intestinal occlusion in case of ovarian carcinoma and carcinomatosis. Case Report: A 62-year-old female patient with ascites, carcinomatosis, unresectable pelvic tumour, and intestinal obstruction suffered a five-step oncosurgery "model": three surgical interventions overlapping chemotherapy administered via the systemic and intraperitoneal route: Step 1: colostomy and partial omentectomy; Step 2: five courses of systemic chemotherapy supported by granulocyte colony-stimulating factor; Step 3: radical surgery - total hysterectomy, bilateral adnexectomy, pelvic lymphadenectomy, omentectomy, appendectomy, pelvic peritonectomy, and hyperthermic intraperitoneal chemotherapy; Step 4: consolidation systemic chemotherapy consisting of three more similar cycles; Step 5: closure of the colostomy. Nine months after the beginning of treatment, the patient is with no evidence of disease. Conclusions: The association of surgical and oncologic treatment and the use of hyperthermic intraperitoneal chemotherapy (HIPEC) technology can solve some of these complex cases.


Keywords

Peritoneal carcinomatosis; Occlusive ovarian cancer; Hyperthermic intraperitoneal chemotherapy.

Cite and Share

B. Moldovan,F. Pescaru,D. Pocreaţă,P. Biriş,A. Moldovan,M.E. Căpîlna. Multimodal oncosurgery approach to treat peritoneal carcinomatosis in a patient with occlusive ovarian carcinoma. European Journal of Gynaecological Oncology. 2016. 37(2);251-253.

References

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[2] Chua T.C., Robertson G.,·Liauw W., Farrell R., Yan T.D., Morris D. L.: “Intraoperative hyperthermic intraperitoneal chemotherapy after cytoreductive surgery in ovarian cancer peritoneal carcinomatosis: systematic review of current results”. J. Cancer Res. Clin. Oncol., 2009, 135, 1637.

[3] Neijt J.P., Engelholm S.A., Tuxen M.K., Sorensen P.G., Hansen M., Sessa C., et al.: “Exploratory phase III study of paclitaxel and cisplatin versus paclitaxel and carboplatin in advanced ovarian cancer”. J. Clin. Oncol., 2000, 18, 3084.

[4] Königsrainer I., Beckert S., Becker S., Zieker D., Fehm T., Grischke E. M., et al.: “Cytoreductive surgery and HIPEC in peritoneal recurrentovarian cancer: experience and lessons learned”. Langenbecks Arch. Surg., 2011, 396, 1077.

[5] Deraco M., Kusamura S., Virzì S., Puccio F., Macrì A., Famulari C., et al.: “Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as upfront therapy for advanced epithelial ovarian cancer: multi-institutional phase-II trial”. Gynecol. Oncol., 2011, 122, 215.

[6] Pomel C., Ferron G., Lorimier G., Rey A., Lhomme C., Classe J.M., et al.: “Hyperthermic intra-peritoneal chemotherapy using oxaliplatin as consolidation therapy for advanced epithelial ovarian carcinoma. Results of a phase II prospective multicentre trial. CHIPOVAC study”. Eur. J. Surg. Oncol., 2010, 36, 589.

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