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      Good Results with Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Perfusion for Recurrent Ovarian Cancer: Presented at ICACT

      By Jill Stein

      PARIS, FRANCE -- February 1, 2006 -- Cytoreductive surgery with intraperitoneal hyperthermic perfusion seems to be an effective and well tolerated treatment for women with recurrent peritoneal ovarian cancer, according to data presented at the 17th International Congress on Anti-Cancer Treatment (ICACT).

      Herwart Muller, MD, Chief of Surgical Oncology, Hammelburg Hospital, Hammelburg, Germany, described on January 31st the results of a study with 49 patients who were treated with cytoreductive surgery and intraperitoneal hyperthermic perfusion plus three cycles of adjuvant chemotherapy.

      The chemotherapy regimen included topotecan and gemcitabine administered according to the Northeastern German Society of Gynecologic Oncology (NOGGO) scheme.

      "Surgery is an essential component of the management of patients with ovarian cancer," Dr. Muller observed. "Unfortunately, the disease often presents at an advanced stage, and the overall survival rate is only 25%."

      "Optimal salvage therapy for recurrent ovarian cancer has not been clearly established, and the response rate for chemotherapy for recurrent disease has ranged from 20% to 30% with an 8- to 12-month length of survival," he added.

      Patients in the present study had been heavily pre-treated with platinum- and/or taxol-based regimens. That is, 79.6% had been resistant to platinum-based treatment, and 67.3% had been resistant to taxol-based treatment.

      Results show that 81.6% patients were cytoreduced to CC 0-1 level of less than 2.5 mm. Two patients had a two-step procedure to achieve complete resection.

      The treatment-related complication rate was 18.8%. There were no deaths as a result of surgery.

      The overall 1-year survival rate was 75%, and the 2-year survival rate was 70% (75% for CC 0-1 resections and 62% for CC 2-3 resections).

      "I think we can say from our results that a second debulking is an effective tool for the management of recurrent ovarian cancer," Dr. Muller pointed out.

      He said that the results also show that taxol and platinum resistance does not seem to be a contraindication to a second debulking.

      He emphasized that the value of perioperative intraperitoneal chemotherapy in this setting is not yet clear.


      [Presentation title: Cytoreductive Surgery Plus Intraperitoneal Hyperthermic Perfusion Plus Adjuvant Chemotherapy in the Treatment of Recurrent Ovarian Cancer.]



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