Department of Surgery, Institut Gustave Roussy and University Paris Sud, Villejuif, France.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):464-7. doi: 10.1016/j.ejogrb.2013.06.041. Epub 2013 Jul 31.
To assess the efficacy and morbidity of cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) for relapsed ovarian granulosa cell tumors (OGCT).
Between 2007 and 2009, patients with relapsed OGCT who had been treated with HIPEC after CRS in our institution were retrospectively analyzed.
We identified 7 patients who had undergone CRS plus HIPEC. Macroscopically complete cytoreduction had been performed in all patients. The location of the recurrence was exclusively the pelvis in 2 cases and both the pelvis and abdomen in 5 cases. We had administered an intraperitoneal perfusion of oxaliplatin (460 mg/m(2)) or oxaliplatin (360 mg/m(2)) plus irinotecan (360 mg/m(2)) heated up to 41-43°C for 30 min. No post-operative mortality nor any grade IV morbidity (according to the Clavien and Dindo classification) had occurred. One lymphocyst (grade III) had appeared which had twice required percutaneous drainage. Six patients had experienced extra-abdominal complications (all grade II). Median follow-up after CRS plus HIPEC was 32 months (range, 25-56). Among the 7 patients, 2 are disease free, 3 had relapsed with peritoneal carcinomatosis and 2 had relapsed with liver metastases.
HIPEC (using oxaliplatin or oxaliplatin plus irinotecan) should not be recommended to treat relapsed OGCT.
评估细胞减灭术(CRS)联合腹腔热灌注化疗(HIPEC)治疗复发性卵巢颗粒细胞瘤(OGCT)的疗效和发病率。
2007 年至 2009 年,我们对在我院接受 CRS 后接受 HIPEC 治疗的复发性 OGCT 患者进行了回顾性分析。
我们确定了 7 例接受 CRS 加 HIPEC 的患者。所有患者均行大体完全肿瘤细胞减灭术。2 例复发部位仅在盆腔,5 例复发部位在盆腔和腹部。我们给予奥沙利铂(460mg/m²)或奥沙利铂(360mg/m²)联合伊立替康(360mg/m²)腹腔内灌注,加热至 41-43°C 持续 30 分钟。无术后死亡,也无任何 4 级发病率(根据 Clavien 和 Dindo 分类)。出现 1 例淋巴囊肿(3 级),需两次经皮引流。6 例发生腹外并发症(均为 2 级)。CRS 加 HIPEC 后中位随访时间为 32 个月(范围 25-56)。7 例患者中,2 例无病生存,3 例复发伴腹膜癌病,2 例复发伴肝转移。
不建议使用 HIPEC(奥沙利铂或奥沙利铂联合伊立替康)治疗复发性 OGCT。