Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancer: A meta-analysis

Hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of ovarian cancer

“…22 Hyperthermia induces the activation of the systemic immune response by activating heat-shock proteins. 8…”

“…It has been suggested that HIPEC may be particularly effective against remaining chemotherapy-resistant cancer cells following neoadjuvant chemotherapy. 8 Patients undergoing interval surgery are likely to have a lower volume of residual disease, correlating with better response.…”

“…There have been two RCTs in the setting of disease recurrence 29,30 with conflicting results (Table 1), and it is of note that the study by Spiliotis et al has been heavily criticised. 8…”

“…Best survival outcomes following primary or interval surgery are associated with achievement of nil macroscopic residual disease (NMRD) at surgery. [3][4][5][6] Despite improvements in outcomes of cytoreductive surgery 7 and survival benefit seen with maintenance treatments, 8 median overall survival following surgery remains low at 29-63 months. 9 Recurrence occurs in 80% of patients, the majority peritoneally.…”

The necessity to adhere to evidence-based indications for hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with ovarian cancer

“…A subgroup analysis revealed that HIPEC improved progression-free survival and overall survival at interval cytoreductive surgery with no increase in morbidity 2. A meta-analysis including both trials confirmed that HIPEC administered at time of optimal interval cytoreductive surgery prolonged survival,3 and has been incorporated into recent National Comprehensive Cancer Network (NCCN) guidelines.…”