Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item Feasibility of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer During COVID-19 Pandemic(2021) Ayhan, Ali; Yilmaz Baran, Safak; Vatansever, Dogan; Dogan Durdag, Gulsen; Celik, Husnu; Taskiran, Cagatay; Akilli, Huseyin; 0000-0001-5874-7324; 0000-0002-5240-8441; 33858953; AAX-3230-2020Objective This study aims to evaluate the effect of the COVID-19 pandemic and related restrictions on patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer. Methods We retrospectively evaluated ovarian cancer patients who underwent HIPEC following complete cytoreductive surgery performed during the outbreak of the COVID-19 pandemic in three different centers specializing in gynecological oncology. All patients who underwent cytoreduction plus HIPEC for a primary, interval, and recurrent surgery were evaluated. Primary outcomes was postoperative 30-day morbidity and mortality. The secondary outcome was infection of patient and/or related staff with COVID-19 during the perioperative or early postoperative period. Results We performed a total of 35 HIPEC procedures during the pandemic: 15 (42.9%) patients underwent primary/interval surgery, while 20 (57.1%) patients had recurrent disease. Grade 3-4 complications occurred in one patient (2.9%) (chronic renal failure), while mortality did not occur in any patient. Neither the patients nor related staff were infected with the coronavirus during the perioperative or early postoperative period. One patient, who was diagnosed with COVID-19 pneumonia on postoperative day 80 died from the infection. Another patient died on postoperative day 85 due to progressive ovarian cancer, a disorder in vital functions, and organ failure. Conclusion HIPEC during the COVID-19 pandemic seems a safe and feasible procedure, with acceptable morbidity and mortality rates. Careful selection of patients is important and precautions should be taken before the procedure.Item Prognostic factors associated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer(2020) Ayhan, Ali; Akilli, Huseyin; 33020918; AAX-3230-2020; AAJ-5802-2021Objective To identify factors affecting survival for women undergoing cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC). Methods A retrospective study at Baskent University School of Medicine, Ankara, Turkey. Data were evaluated for 71 women with recurrent ovarian cancer who underwent cytoreductive surgery with R0 resection plus HIPEC between 2016 and 2019. Potential factors affecting survival (platinum sensitivity, bevacizumab administration before HIPEC, albumin and CA125 levels, presence of ascites, age, number of chemotherapy lines, and time interval between last chemotherapy and HIPEC) were evaluated. Complications of HIPEC were documented. Results The median age was 58 years, and the median follow-up was 12 months. In univariate analyses, platinum sensitivity, albumin level, and time since last chemotherapy cycle affected overall survival. In multivariate Cox regression analysis, use of bevacizumab before HIPEC (hazard ratio [HR], 6.7; 95% confidence interval [CI], 1.39-32.3; P=0.018) and presence of ascites (HR, 5.3; 95% CI, 1.65-17.5; P=0.005) were independent negative prognostic factors. Seven (8.9%) women experienced grade III-IV complications. Conclusion In recurrent ovarian cancer, HIPEC is a promising treatment with mild-to-moderate toxicity. However, the presence of ascites and progression under bevacizumab treatment before HIPEC seem to be negative prognostic factors; these findings will be important for patient selection.