Advanced Ovarian Cancer: Does Adding HIPEC to Cytoreductive Surgery Improve Outcomes?
Posted: Wednesday, November 4, 2020
According to research published in JAMA Network Open, hyperthermic intraperitoneal chemotherapy (HIPEC) in addition to primary cytoreductive surgery may be beneficial for patients with stage III epithelial ovarian cancer. Jiahong Wang, MD, of Guangzhou Medical University in China, and colleagues found that, when paired with cytoreductive surgery, HIPEC was associated with improvement in long-term survival.
Conducted from January 2010 to May 2017, the cohort study included 584 patients with stage III epithelial ovarian cancer who underwent primary cytoreductive surgery either alone (27.2%) or in conjunction with HIPEC (72.8%). Patients in the chemotherapy group experienced superior median overall survival (49.8 months vs. 34.0 months; 95% confidence interval [CI] = 28.9–41.5 months) and superior 3-year overall survival (60.3% vs. 49.5%; 95% CI = 41.0%–57.4%).
These results were consistent with survival outcomes for subgroups stratified by completeness of surgery, where patients undergoing chemotherapy achieved significantly better survival outcomes than did those undergoing surgery alone. However, the margin for superiority in the 3-year survival rates within the incomplete-surgery subgroup was slimmer by comparison. Complete surgery was defined as residual disease measuring up to 1 cm in diameter; incomplete surgery was defined as the presence of one or more residual nodules measuring more than 1 cm in diameter.
Within the complete-surgery subgroup, patients receiving chemotherapy experienced superior median overall survival (53.9 months vs. 42.3 months; 95% CI = 31.1–59.3 months; P = .02) and superior 3-year overall survival (65.9% vs. 55.4%; 95% CI = 44.7%–64.8%; P = .04). Patients in the incomplete-surgery subgroup who received chemotherapy also experienced superior median overall survival (29.2 months vs. 19.9 months; 95% CI = 11.6–39.1 months; P = .03) and 3-year overall survival (44.3% vs. 36.7%; 95% CI = 23.4%–50.1%; P = .19) than did those not receiving chemotherapy.
Disclosure: The study authors reported no conflicts of interest.