HIPEC as Up-Front Treatment in Locally Advanced Ovarian Cancer
by
, , and
Michail Karanikas
1,
Konstantinia Kofina
1,*,
Dimitrios Kyziridis
2,
Grigorios Trypsianis
3,
Apostolos Kalakonas
4 and
Antonios-Apostolos Tentes
2 1
1st Department of Surgery, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
2
Department of Surgical Oncology, Peritoneal Surface Malignancy Program, EUROMEDICA Kyanous Stavros, 54644 Thessaloniki, Greece
3
Department of Medical Statistics, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece
4
Department Anesthesiology, EUROMEDICA Kyanous Stavros, 54644 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(20), 3500; https://doi.org/10.3390/cancers16203500
Submission received: 10 September 2024
/
Revised: 3 October 2024
/
Accepted: 12 October 2024
/
Published: 16 October 2024
(This article belongs to the Special Issue Research on Surgical Treatment for Ovarian Cancer)
Simple Summary
This study evaluated the effect of hyperthermic intraperitoneal chemotherapy with complete or near-complete cytoreduction on naïve ovarian cancer women; 5- and 10-year overall survival, disease-specific survival, and disease-free survival rates were significantly higher in these patients. These patients were also 67% less likely to die from any cause, 75% less likely to die from cancer, and 46% less likely to develop recurrence compared to patients that were treated with cytoreductive surgery alone. These favorable results highlight the need for future randomized controlled trials in order to further determine the effect of hyperthermic intraperitoneal chemotherapy.
Abstract
Purpose: The main objective of the study is to evaluate the effect of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of naïve ovarian cancer women undergoing complete or near-complete cytoreduction by assessing the overall survival, the disease-specific survival, and the disease-free survival. The secondary objective is the identification of prognostic indicators of survival and recurrence of these patients. Patients—Methods: Retrospective study of treatment in naïve women with locally advanced ovarian cancer treated with cytoreductive surgery (CRS) and HIPEC and compared with those who were treated with cytoreduction alone. Clinicopathologic variables were correlated to overall survival, disease-specific survival, and disease-free survival using Kaplan–Meier method, and the multivariate Cox proportional hazards regression models. Results: 5- and 10-year overall survival, disease-specific survival, and disease-free survival rates were significantly higher in patients treated with CRS and HIPEC. These patients were 67% less likely to die from any cause (adjusted hazard ratio, aHR = 0.33, p = 0.001), 75% less likely to die from cancer (aHR = 0.25, p = 0.003), and 46% less likely to develop recurrence (aHR = 0.54, p = 0.041) compared to patients treated with CRS alone. Moreover, the poor performance status (aHR = 2.96, p < 0.001), the serous carcinomas (aHR = 0.14, p = 0.007), and the morbidity (aHR = 6.87, p < 0.001) were identified as independent indicators of poor overall survival. The degree of differentiation (aHR = 8.64, p = 0.003) was identified as the independent indicator of disease-specific survival (aHR = 4.13, p = 0.002), while the extent of peritoneal carcinomatosis (aHR = 2.32, p < 0.001) as the independent indicator of disease-free survival. Conclusions: Treatment in naïve patients with locally advanced ovarian cancer undergoing CRS plus HIPEC appears to have improved overall, disease-specific, and disease-free survival.
Keywords:
ovarian cancer; cytoreductive surgery; HIPEC; survival
