Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Debate 15B - Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
No
from Section III - Ovarian Cancer
Published online by Cambridge University Press: 20 July 2023
Book contents
- 50 Big Debates in Gynecologic Oncology
- 50 Big Debates in Gynecologic Oncology
- Copyright page
- Contents
- Contributors
- Section I Perioperative Management
- Section II Screening, Prevention, and Early Diagnosis
- Section III Ovarian Cancer
- Debate 5A Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Debate 5B Should CA-125 Surveillance be Performed after Completion of Primary Treatment for Ovarian Cancer Patients in Remission?
- Chapter 6A In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 6B In Patients with BRCA-negative and HRD-negative Epithelial Ovarian Cancer, Should Molecular Profiling be Routinely Done to Guide Adjuvant Therapy?
- Debate 7A Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 7B Is MEK Inhibitor Therapy the Best Treatment Recommendation for Low-Grade Serous Ovarian Cancer Patients at First Relapse?
- Debate 8A Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 8B Should Stage IC Mucinous Ovarian Carcinoma be Managed by Observation or Adjuvant Chemotherapy?
- Debate 9A How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 9B How Many Cycles of Adjuvant Chemotherapy Should be Administered to Patients with High-risk Stage I Epithelial Ovarian Cancer?
- Debate 10A Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 10B Patients with Advanced Ovarian Cancer who are 75 Years Old and Above Should Routinely be Treated with Neoadjuvant Chemotherapy?
- Debate 11A Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 11B Should an Attempt at Aggressive Cytoreduction be Made for all Surgical Candidates with Advanced Ovarian Cancer prior to Treatment with Adjuvant Chemotherapy?
- Debate 12A Should Minimally Invasive Modalities be Routinely/Uniformly Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 12B Should Laparoscopic Modalities be Routinely Utilized for Assessment of Resectability prior to Attempted Primary Debulking in Patients with Advanced Ovarian Cancer?
- Debate 13A Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 13B Should Enlarged Supradiaphragmatic Lymph Nodes be Routinely Removed during Debulking Surgery Procedures for Patients with Advanced Ovarian Cancer?
- Debate 14A Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 14B Is there a Role for Hyperthermic Intraperitoneal Chemotherapy in Front-line Therapy for Ovarian Cancer?
- Debate 15A Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 15B Is there a Role for Intraperitoneal Chemotherapy after Optimal Cytoreduction of Ovarian Cancer?
- Debate 16A What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 16B What is the Best Front-line Maintenance Therapy for HRD-positive Ovarian Cancer?
- Debate 17A When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 17B When is the Best Time to Use PARP Inhibitors for Maintenance?
- Debate 18A What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer? Bevacizumab
- Debate 18B What is the best front-line maintenance therapy for optimally debulked HRD-negative advanced epithelial ovarian cancer?
- Debate 19A What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer
- Debate 19B What is the Optimal Therapeutic Option for Platinum-resistant Recurrent Ovarian Cancer?
- Debate 20A Should Patients with Platinum-sensitive Recurrent Ovarian Cancer Undergo Secondary Cytoreduction prior to Receiving Platinum-containing Second-line Chemotherapy?
- Debate 20B Should All Patients with Platinum-sensitive Recurrent Ovarian Cancer be Considered for Secondary Cytoreduction prior to Receiving Second-line Platinum Chemotherapy?
- Debate 21A Should Tertiary Debulking for Patients with Recurrent Ovarian Cancer be Performed?
- Debate 21B Should Tertiary Debulking be Performed for Patients with Recurrent Ovarian Cancer?
- Debate 22A Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 22B Is there a Role for Immunotherapy in Ovarian Cancer?
- Debate 23A What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 23B What is the Best Management Option for Malignant Bowel Obstruction?
- Debate 24A What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 24B What is the Optimal Chemotherapy Regimen for Ovarian Germ-cell Tumors?
- Debate 25A What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 25B What is the Optimal Adjuvant Chemotherapy Regimen for Primary Granulosa Cell Tumor?
- Debate 26A What is the Best Management Strategy for a Recurrent Granulosa Cell Tumor?
- Debate 26B What is the Best Management Strategy for Recurrent Granulosa Cell Tumor?
- Debate 27A Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Debate 27B Is progression-free survival a rational surrogate endpoint in front-line ovarian cancer clinical trials?
- Section IV Endometrial Cancer
- Section V Cervical Cancer
- Section VI Vaginal and Vulvar Cancer
- Index
- References
Summary
Intraperitoneal (IP) chemotherapy, the delivery of unheated chemotherapy into the peritoneal cavity through a catheter connected to an implanted port, was once a strongly recommended, though controversial, treatment for women with advanced ovarian cancer after optimal cytoreductive surgery. Historically, direct drug delivery to the IP cavity and improved pharmacokinetics yielded improved progression-free and overall survival outcomes. However, the improved disease control and survival came at the cost of significantly increased toxicity, worse quality of life, and added expense. The most recent randomized clinical trial of IP therapy identified a less toxic regimen but failed to demonstrate any survival benefit. The negative results of this study, taken in the setting of more recent advances in biologic therapies, illustrate that in the modern therapeutic landscape for ovarian cancer there is no role for IP chemotherapy. IP therapy is too toxic, too expensive, and historical IP therapy survival outcomes are no longer relevant.
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- Information
- 50 Big Debates in Gynecologic Oncology , pp. 85 - 87Publisher: Cambridge University PressPrint publication year: 2023
References
NCI alert (2006). Available from: https://wayback.archive-it.org/org-350/20211101182949/https://www.nlm.nih.gov/databases/alerts/ovarian_ip_chemo.htmlGoogle Scholar
Tewari, D, et al. Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced ovarian cancer: a gynecologic oncology group study. J Clin Oncol 2015;33:1460–1466.CrossRefGoogle ScholarPubMed
Walker, JL, et al. Randomized trial of intravenous versus intraperitoneal chemotherapy plus bevacizumab in advanced ovarian carcinoma.J Clin Oncol 2019;37(16):1380–1390. https://doi.org/10.1200/JCO.18.01568CrossRefGoogle ScholarPubMed
Wright, JD, et al.Utilization and toxicity of alternative delivery methods of adjuvant chemotherapy for ovarian cancer. Obstet Gynecol 2016;127(6):985–991.Google Scholar
Havrilesky, LJ, et al. Gynecologic Oncology Group. Cost effectiveness of intraperitoneal compared with intravenous chemotherapy for women with optimally resected stage III ovarian cancer: a Gynecologic Oncology Group study. J Clin Oncol 2008;26(25):4144–4450.CrossRefGoogle ScholarPubMed