Natural Conception after Fertility-Conserving Cytoreductive Surgery (FCCRS) and Heated Intraperitoneal Chemotherapy (HIPEC) with the Oxaliplatin Protocol: A Case Report

摘要

After 30 years, the combined treatment strategy of cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) has increased the survival expectancy of carcinomatosis patients. Fertility-sparing cytoreductive surgery (FSCRS) may now be considered in some instances mainly in young women who desire future pregnancy. The aim of this report is to record the first case of natural conception with uneventful term pregnancy and delivery following FSCRS and HIPEC with the oxaliplatin protocol in a pseudomyxoma peritonei (PMP) patient. We report the case of a 31 year-old female affected of PMP referred to our department for further treatment. In January 2007, she underwent an extensive CRS – with a FSCRS during the pelvic peritonectomy – and HIPEC according to the oxaliplatin protocol. Her postoperative recovery was uneventful. Two years later the patient had natural pregnancy and a caesarean delivery with no evidence of residual disease. Seven years after her FRSCRS with HIPEC, the patient remains disease-free. To our knowledge, this is the first report of natural conception with successful term delivery following oxaliplatin protocol. Based on our own experience and on the ten clinical cases previously reported in the literature, it appears that FSCRS may now be considered a good alternative and that childbearing should even be possible in selected cases of young women with peritoneal carcinomatosis.