Impact of Intraperitoneal Chemotherapy on Survival in Advanced Ovarian Cancer
Posted: Thursday, March 22, 2018
The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery improves both overall and recurrence-free survival in patients with stage 3 epithelial ovarian cancer versus surgery alone, based on the findings of a phase III trial. The results of this multicenter, open-label study were published by Willemien Van Driel, MD, PhD, of the Netherlands Cancer Institute in Amsterdam, Netherlands, and colleagues in The New England Journal of Medicine.
Over a 10-year period, all of the 245 women enrolled received 3 cycles of carboplatin and paclitaxel before cytoreductive surgery and 3 cycles of the same chemotherapy regimen following surgery. Half of the women were randomized to receive the addition of HIPEC with cisplatin during surgery, whereas the other half received no HIPEC.
In patients who received surgery plus HIPEC, disease recurrence or the rate of death was significantly lower than in patients who had surgery alone, with a hazard ratio of 0.66 (P = .003). Disease recurrence or death occurred in 81% of patients who had surgery plus HIPEC versus 89% of patients who had surgery alone, with a median follow-up of about 5 years.
The median recurrence-free survival was 10.7 months in the surgery group versus 14.2 months in the surgery-plus-HIPEC group, and the median overall survival was approximately 12 months longer in the surgery-plus-HIPEC group. Both groups had a similar side-effect profile, suggesting the addition of HIPEC was well tolerated.
