Ovarian cancer: HIPEC with surgery improves survival

  • Lei Z & al.
  • JAMA Netw Open
  • 3 Aug 2020

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to primary cytoreductive surgery (PCS) improves OS in patients with stage III primary epithelial ovarian cancer.
  • Patients with complete surgery show 3-year OS benefit with HIPEC.

Why this matters

  • The National Comprehensive Cancer Network recommends incorporation of intraperitoneal therapy into the management of advanced-stage ovarian cancer.
  • Previous studies have shown survival benefits with HIPEC in ovarian cancer; however, large-scale, multicenter trials are lacking.

Study design

  • 584 patients with stage III primary epithelial ovarian cancer were treated with either PCS alone (n=159) or PCS with HIPEC (n=425).
  • Funding: National Natural Science Foundation of China.

Key results

  • Median follow-up: 42.2 months.
  • The median OS in HIPEC and PCS-alone group:
    • All patients: 49.8 vs 34.0 months (HR, 0.63; P<.001>
    • Patients with complete surgery: 53.9 vs 42.3 months (weighted HR, 0.67; P=.02).
    • Patients who received incomplete surgery: 29.2 vs 19.9 months (weighted HR, 0.65; P=.03).
  • The 3-year OS rate between the groups improved in patients with complete surgery, but not significantly in those who received incomplete surgery.
  • The most common grade 3/4 adverse events were electrolyte disturbance, anemia, leukopenia, and neutropenia.
  • Rate of grade 3/4 electrolyte disturbance was significantly higher in the HIPEC group (28.1% vs 11.5%; P<.001>

Limitations

  • Retrospective.