A Pilot Study of Acute Normovolemic Hemodilution in Patients Undergoing Cytoreductive Surgery for Advanced Ovarian Cancer
- The study population will include women with a high preoperative suspicion of
advanced primary epithelial ovarian, fallopian tube, or primary peritoneal carcinoma
(Stage IIIC or IV) as determined by CT or MRI of abdomen and pelvis planning to
undergo exploratory laparotomy and surgical cytoreduction with the operative goal of
this procedure to achieve optimal cytoreduction to less than 1 cm of residual
- Age ≥ 18 years and < 70 years.
- Preoperative hemoglobin concentration ≥ 10 mg/dL within 30 days of registration.
- Based on surgeon's assessment, patient is recommended to undergo cytoreductive
surgery via laparotomy with the operative goal of this procedure to achieve optimal
cytoreduction to less than 1 cm of residual disease.
- Hemoglobin < 10 g/dL.
- Serum albumin < 3g/dL.
- GOG performance status > 2.
- Active coronary artery disease (defined as unstable angina or a positive cardiac
- Patients with a history of coronary artery disease may be included if they have had a
normal cardiac stress test within 30 days of enrollment.
- History of cerebrovascular disease.
- Renal insufficiency with serum creatinine > 1.6.
- Uncontrolled hypertension.
- Restrictive or obstructive pulmonary disease.
- Congestive heart failure.
- Active infection.
- Refusal to accept allogenic or autologous blood transfusion.
- Autologous blood transfusion within last 30 days or plan to donate autologous blood
prior to surgery.
- Plan for exploratory laparoscopy prior to laparotomy for assessment of disease
- Surgeon has high suspicion (>50% chance) that cytoreductive surgery will be aborted
due to inability to achieve optimal cytoreduction to < 1cm residual disease.