What is the role of hyperthermic intraperitoneal chemotherapy in the treatment of ovarian cancer?

Updated: Dec 06, 2018
  • Author: Shannon M Grabosch, MD; Chief Editor: from Memorial Sloan-Kettering - Yukio Sonoda, MD  more...
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Answer

Answer

While used as standard treatment in other malignancies, such as appendiceal cancer, hyperthermic intraperitoneal chemotherapy (HIPEC) has been less adopted in the treatment of ovarian cancer, given logistical considerations in administration and concern for postoperative complications.

Several smaller European and Korean studies have demonstrated a benefit in PFS and OS in optimally debulked patients at the time of their primary surgery. [58, 59, 61, 62]  Additionally, a large-scale study of 245 patients reported longer recurrence-free survival and OS with surgery plus HIPEC than with surgery alone. Study patients were randomized at the time of optimal interval debulking surgery after receiving three cycles of neoadjuvant carboplatin AUC 5-6 IV and paclitaxel 175 mg/mto either receive HIPEC with cisplatin 100 mg/mor not. Median recurrence-free survival was 10.7 months in the surgery arm and 14.2 months in the surgery-plus-HIPEC arm; median overall survival was 33.9 months versus 45.7 months, respectively. [63]  Patients in the two arms had similar rates of postoperative adverse events.

HIPEC in recurrent ovarian cancer has been studied somewhat more extensively but largely in a retrospective manner with a variety of treatment regimens. It has not been widely adopted as a standard treatment regimen.


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