ORIGINAL RESEARCH article
Front. Med.
Sec. Obstetrics and Gynecology
This article is part of the Research TopicCutting-Edge Strategies in Screening, Prevention, and Treatment in Gynaecologic OncologyView all 45 articles
TERTIARY CYTOREDUCTION FOR RECURRENCE OF OVARIAN CANCER PATIENTS AFTER INTRAPERITONEAL CHEMOTHERAPY
Provisionally accepted
GIUSI SANTANGELO1*
enrico ciminello2
Tullio Golia D'Augè1
Giuseppe Caruso1
Violante Di Donato1
Federica Tomao1
Innocenza Palaia1
Margherita FISCHETTI1
Giorgio Bogani3
Ludovico Muzii1Pierluigi BENEDETTI PANICI1Giorgia PERNIOLA1- 1Universita degli Studi di Roma La Sapienza, Rome, Italy
- 2Istituto Superiore di Sanita, Rome, Italy
- 3Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Introduction: This study evaluated the feasibility, complications, and outcomes of a tertiary cytoreduction after second-line treatment with IP (intraperitoneal) versus IV (intravenous) chemotherapy in recurrent ovarian cancer (ROC) patients. Methods: We retrospectively collected data of patients treated with an optimal tertiary cytoreduction. At the second relapse, the patients underwent optimal secondary surgery followed by IP chemotherapy (case group) or by IV chemotherapy (control group). Differences in treatment-related morbidity rate, pattern of recurrence, and oncologic outcomes were evaluated by Mann-Whitney and Chi-Squared. Kaplan-Meier and frailty model for recurrent events were used to assess statistical significance in differences of disease-free survival. Results: Charts of 60 patients with a second ROC were identified. The patients with extensive peritoneal carcinomatosis or an inaccessible abdominal cavity were excluded. Twenty-nine patients (48.3%) who underwent optimal tertiary cytoreduction were included: 16 and 13 patients were from the IP and IV groups, respectively. At the second relapse, 56.2% of patients in the IP group and 61.5% in the IV group presented oligometastatic disease, respectively. The adhesions were significantly more represented in the IP group than the IV group (p=0.01). Days to the first flatus were significantly different in the two groups (4.2 in IP group and 2.5 days in IV group, p<0.01). Conclusion: The present study showed that IP chemotherapy does not represent an obstacle to surgery in ROC patients. The surgery after IP is feasible. No significant differences in terms of complications and outcomes were observed in the two groups.
Keywords: Recurrent ovarian cancer, Intraperitoneal chemotherapy, Intravenous chemotherapy, tertiary cytoreduction, Adhesion score
Received: 22 Aug 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 SANTANGELO, ciminello, Golia D'Augè, Caruso, Di Donato, Tomao, Palaia, FISCHETTI, Bogani, Muzii, BENEDETTI PANICI and PERNIOLA. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: GIUSI SANTANGELO
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