abstract
PURPOSE:
Cytoreductive
surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)
have been used in adults with ovarian carcinoma proving overall survival
benefit in randomized trials, but measured in months. Diffuse
peritoneal disease from pediatric type ovarian tumors is rare. We
applied CRS and HIPEC to pediatric girls with diffuse peritoneal disease
as part of a clinical trial.
METHODS:
In all patients complete cytoreduction was followed by HIPEC using 100 mg/m2
of cisplatin for 90 min in a closed technique. All received neoadjuvant
chemotherapy. Patients with disease outside of the abdominal cavity
were excluded.
RESULTS:
Of
101 pediatric CRS and HIPEC operations, 8 had ovarian primary tumors
and multifocal peritoneal disease. There were three yolk sac tumors
(germ cell, mixed teratoma), one Sertoli-Leydig, one PNET of the ovary,
one choriocarcinoma, one juvenile granulosa cell tumor and one
adenocarcinoma. Age ranged 4-18 years. Three of the 8 (37 %) recurred
and died. The remaining 63 % are disease free 2-6 years post HIPEC.
Overall survival and relapse-free survival in this cohort was 64 and
62 %, respectively [CI 0.64 (0.34, 1); 0.62 (0.37, 1)].
CONCLUSIONS:
This
is the first report of CRS and HIPEC in pediatric ovarian tumors. HIPEC
may be effective in pediatric-type ovarian tumors. More study is needed
in a larger cohort.
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