HIPEC May Not Enhance Outcomes for Recurrent Epithelial Ovarian Cancer
A groundbreaking study has found that the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to secondary cytoreductive surgery (SCS) does not significantly improve progression-free survival (PFS) for patients with platinum-sensitive recurrent epithelial ovarian cancer. Published in the Journal of Clinical Oncology, the research suggests that HIPEC should not be used in women undergoing SCS without neoadjuvant therapy.
Study Findings
After a median follow-up of 83 months, the median PFS was 23 months for patients undergoing SCS alone and 25 months for those receiving SCS with HIPEC. The probability of postrecurrence survival (PRS) at five years was 61.6% for SCS alone and 75.9% for SCS with HIPEC. Out of 167 patients, 135 experienced a recurrence, and 72 died from any cause.
Safety and Side Effects
The study reported no significant difference in the incidence of postoperative side effects between the two groups. Severe or life-threatening side effects were observed in 7.1% of the surgery alone group and 12.2% of the surgery with HIPEC group. Importantly, no deaths were reported within 30 and 90 days post-surgery in either group.
Patient Eligibility and Treatment Details
Eligible patients had a platinum-free interval of six months or more and were referred for SCS if the disease was considered completely resectable. Patients with ascites, recurrences other than primary, or an estimated life expectancy of four weeks or less were excluded. HIPEC was administered at 75 milligrams per square meter of cisplatin for 60 minutes at 41.5 degrees Celsius at the end of surgery.
Conclusion
The study concluded that there is no additional benefit in PFS for patients with platinum-sensitive recurrent ovarian cancer treated with SCS plus platinum-based HIPEC compared to complete SCS alone. Furthermore, no extra toxicity related to HIPEC was reported, underscoring the similar safety profiles of both treatment approaches.
Reference:
"Hyperthermic Intraperitoneal Chemotherapy in Platinum-Sensitive Recurrent Ovarian Cancer: A Randomized Trial on Survival Evaluation (HORSE; MITO-18)," By Dr. Anna Fagotti et al. Journal of Clinical Oncology.
