HIPEC After Initial CRS in Patients Who Have Received NACT

Eligibility Criteria

• 1. Histologically confirmed cancer of the ovary, fallopian tube or peritoneum.
• 2. Women of all races and ethnicities are eligible for this trial.
• 3. Age \> 18.
• 4. The patient must have documented disease limited to the abdomen and pelvis that is amenable to complete CRS indicated by:
• 1. Disease confined to the peritoneal surfaces.
• 2. No clinical or radiological evidence of hematogenous or distant (extra-abdominal) nodal metastasis.
• 5. Evidence of response to NACT must as documented by at least one of the following: decline in serum CA125 level, at least a 30% decrease in the sum of the longest diameter of target lesions on radiographic imaging, or resolution of ascites or pleural effusion(s).
• 6. Gynecologic Oncology Group (GOG) performance status \<= 2
• 7. Leukocytes \>= 3,000/microliter (mcL), absolute neutrophil count \>= 1,500/mcL, platelets \>= 100,000/mcL
• 8. Adequate hepatic function as measured by total bilirubin within normal institutional limits, aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase (SGOT))/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase (SGPT)) =\< 2.5 x institutional upper limit of normal
• 9. Creatinine within normal institutional limits OR creatinine clearance \>= 60 mL/min for patients with creatinine levels above institutional normal
• 10. Albumin \>= 2.5 mg/dL
• 11. Satisfactory cardiopulmonary function (no history of severe congestive heart failure or severe pulmonary disease, as indicated by clinically acceptable risks to undergo major abdominal surgery
• 12. Voluntary participation after getting written informed consent
• 1. Prior chemotherapy (other than NACT) or whole abdomen radiation for ovarian, fallopian tube or primary peritoneal cancers.
• 2. Patients with an active second malignancy regardless of site.
• 3. Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• 4. Pregnant or breast-feeding patients
• 5. Patients who are receiving other oncologic investigational therapeutic agents
• 6. Patients receiving NACT whose disease has progressed following at least 3 cycles of platinum-based therapy, defined by at least one of the following: clinical deterioration (new or worsening of existing ascites, carcinomatous ileus, malignant bowel obstruction, declining performance status); new lesion(s) or increase in maximal diameter of \> 20% of the two largest target lesions; rising CA-125 (an increase of at least 10% of baseline value that increases over 3 values obtained every 21 days).
• 7. Cardiac or pulmonary conditions that preclude aggressive cytoreductive surgery.
• 8. Patients found to have non-gynecologic cancer at the time of surgery.
• 9. Patients with gynecologic malignancy of low-grade serous or borderline histology.