Objective:

To compare overall survival (OS) and progression-related outcomes between patients receiving standard multimodal treatment with intraoperative HIPEC and those without HIPEC for primary advanced or recurrent EOC, and to evaluate postoperative complications as part of this comparison.

Approach:

Key Findings:

• Significant improvement in OS among patients with primary ovarian cancer receiving HIPEC (HR = 0.74, 95% CI, 0.60 to 0.92).
• No improvement in OS in the recurrent setting (HR = 1.08, 95% CI, 0.62 to 1.90).
• No significant differences in progression-related outcomes or postoperative complications across both settings.

Interpretation:

HIPEC may benefit selected patients with primary advanced EOC, particularly in trials evaluating its use during interval debulking surgery, but the evidence is limited and heterogeneous, warranting cautious interpretation.

Limitations:

• Limited number of RCTs included (six RCTs with moderate-quality evidence).
• Heterogeneity in study designs and patient populations.
• Potential biases in the included studies due to their moderate quality.

Conclusion:

HIPEC may provide a survival benefit in selected patients with primary advanced ovarian cancer, but its role in recurrent ovarian cancer remains unestablished.

Sources:

• Systematic Review Registration
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