Efficacy and safety of hyperthermic intraperitoneal chemotherapy in treatment of primary or recurrent ovarian cancer: systematic review and meta-analysis - Report - MDSpire
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Efficacy and safety of hyperthermic intraperitoneal chemotherapy in treatment of primary or recurrent ovarian cancer: systematic review and meta-analysis
Effectiveness and Safety of Hyperthermic Intraperitoneal Chemotherapy for Ovarian Cancer
Overview
This systematic review and meta-analysis evaluates the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in improving overall survival (OS) and progression-related outcomes in patients with primary and recurrent epithelial ovarian cancer (EOC). The findings suggest a significant OS benefit for HIPEC in primary advanced EOC, while no such benefit was observed in recurrent cases.
Background
Epithelial ovarian cancer (EOC) is the leading cause of mortality among gynecologic cancers, with many patients diagnosed at advanced stages. The standard treatment involves primary debulking surgery followed by systemic chemotherapy. HIPEC has emerged as a potential adjunctive treatment, but its role in improving outcomes remains debated.
Data Highlights
Setting
Overall Survival Hazard Ratio (HR)
Progression-Related Outcomes HR
Primary EOC
0.74 (95% CI, 0.60 to 0.92)
0.71 (95% CI, 0.43 to 1.18)
Recurrent EOC
1.08 (95% CI, 0.62 to 1.90)
1.54 (95% CI, 1.00 to 2.37)
Key Findings
HIPEC significantly improves overall survival in patients with primary advanced EOC.
No survival benefit was observed for HIPEC in recurrent EOC cases.
Progression-related outcomes did not show significant differences between HIPEC and non-HIPEC groups.
HIPEC is considered a safe treatment option for selected patients with ovarian cancer.
The evidence supporting HIPEC is based on moderate-quality randomized controlled trials.
Clinical Implications
Clinicians should consider HIPEC as a potential treatment option for selected patients with primary advanced EOC, particularly during interval debulking surgery. However, the lack of benefit in recurrent cases suggests that HIPEC should not be routinely used in this setting.
Conclusion
HIPEC may offer survival benefits for specific patients with primary advanced EOC, but its role in recurrent cases remains unclear, necessitating careful patient selection and further research.
