HIPEC in Ovarian Cancer Is the Future… and Always Will Be? Results from a Spanish Multicentric Survey
by
, , , ,
Alida González Gil
1
,
Álvaro Cerezuela Fernández-de Palencia
2,
Álvaro Jesús Gómez Ruiz
2,
Elena Gil Gómez
1,
Francisco López Hernández
2,
Aníbal Nieto Ruiz
3,
Jerónimo Martínez
4,
Iván Marhuenda
2 and
Pedro Antonio Cascales Campos
1,* 1
Departamento de Cirugía, Unidad de Cirugía Oncológica Peritoneal, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain
2
Servicio de Cirugía General y del Aparato Digestivo, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain
3
Departamento de Ginecología y Obstetricia, Unidad de Ginecología Oncológica, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain
4
Departamento de Oncología Médica, Hospital Clínico Universitario Virgen de la Arrixaca, IMIB-ARRIXACA, 30120 Murcia, Spain
*
Author to whom correspondence should be addressed.
Cancers 2023, 15(13), 3481; https://doi.org/10.3390/cancers15133481
Submission received: 6 May 2023
/
Revised: 29 May 2023
/
Accepted: 1 July 2023
/
Published: 4 July 2023
(This article belongs to the Special Issue Advances in Cytoreductive Surgery and Intraperitoneal Chemotherapy)
Simple Summary
Treatment with intraperitoneal hyperthermic chemotherapy (HIPEC) has been criticized in ovarian cancer due to the lack of prospective and randomized clinical trials demonstrating its efficacy in improving outcomes. However, the publication of the Dutch clinical trial five years ago has not changed the usual clinical practice within the Spanish peritoneal oncologic surgery group. In this paper we analyze and reflect on the future of this technique in patients with peritoneal dissemination of ovarian cancer.
Abstract
Ovarian cancer is the leading cause of death due to gynecological tumors in the female population. Despite optimal first-line treatment, including cytoreduction and platinum-based systemic chemotherapy, recurrences are frequent. The use of hyperthermic intraperitoneal chemotherapy (HIPEC) has been criticized, especially because of the lack of randomized controlled trials (RCTs) with convincing results to support the use of HIPEC in patients with ovarian cancer with peritoneal dissemination. In 2018, the clinical trial published by Van Driel et al. reported improved outcomes in favor of HIPEC treatment with cisplatin. In this study, we conducted a national survey within the Spanish group of peritoneal surgical oncology (Grupo Español de Cirugía Oncológica Peritoneal, GECOP) to explore the impact of the results of this RCT on clinical practice. A total of 33 groups completed the survey. Routine clinical practice was not changed in 28 of the 33 groups (85%) based on the results of the Van Driel trial. Despite the results of this RCT, most groups considered that more RCTs are needed and that, in the future, HIPEC may become the standard of care. In conclusion, the results from RCTs evaluating HIPEC treatment in patients with ovarian cancer has not been transferred to clinical practice.
