Modified port implantation for intraperitoneal chemotherapy: a retrospective analysis of cycle completion and survival in ovarian cancer

Abstract

Background: Intraperitoneal chemotherapy (IPCT) has been shown to improve survival in patients with stage III and IV ovarian cancers. However, its utilization has declined due to high discontinuation rates often attributed to catheter related complications, toxicity of IPCT, and decreased quality of life from abdominal pain. A modified port insertion technique may help reduce chemotherapy and port complications, offering chemotherapy in outpatient settings. Methods: This retrospective study included 72 patients who underwent IPCT at a single institution, Women's Cancer Centre from January 2005 to May 2016. Results: The median number of IPCT cycles administered was six. Completion rates were as follows: 52 patients (73.2%) completed 4 cycles, 47 patients (66.2%) completed 6 cycles, and 29 patients (40.84%) completed 8 cycles. Patients receiving 7 cycles or more had a significantly longer average survival period (64.76 +/- 5.38 months) compared to those receiving 6 cycles or fewer (41.27 +/- 5.77 months) (p = 0.004). Port-related issues were the primary reason for therapy discontinuation in the majority of cases (11.1%) in concord with other studies. Additional factors associated with discontinuation before 7 cycles included neoadjuvant chemotherapy, presence of adhesions, port and systemic infections, severe abdominal pain, and family history of genitourinary cancer. Conclusions: The modified port implantation technique increases delivery of IPCT cycles, potentially enhancing treatment efficacy. IPCT provides a promising, office-based maintenance therapy option with significant survival benefits.