The prognosis impact of hyperthermic intraperitoneal chemotherapy (HIPEC) plus cytoreductive surgery (CRS) in advanced ovarian cancer: the meta-analysis

Abstract

Background and objective Previous studies about the prognostic value of the HIPEC have yielded controversial results. Therefore, this study aims to assess the impact of HIPEC on patients with ovarian cancer. Results We included 13 comparative studies, and found that the overall survival (OS) and progression-free survival (PFS) in HIPEC groups were superior to groups without HIPEC treatment in the all total population (HR = 0.54,95% CI:0.45 to 0.66, HR = 0.45, 95% CI: 0.32 to 0.62). Additionally, the subgroup analysis showed that patients with advanced primary ovarian cancers also gained improved OS and PFS benefit from HIPEC (HR = 0.59,95% CI:0.46 to 0.75, HR = 0.41,95% CI:0.32 to 0.54). With regard to recurrent ovarian cancer, HIPEC was associated with improved OS (HR = 0.45,95% CI:0.24 to 0.83), but for the PFS, no correlation was observed between HIPC group and the non-HIPEC group (HR = 0.55,95% CI:0.27 to 1.11). HIPEC also led to favorable clinical outcome (HR = 0.64,95% CI:0.50 to 0.82, HR = 0.36,95% CI:0.20 to 0.65) for stage III or IV ovarian cancer with initial diagnosis. Conclusion The review indicated that HIPEC-based regimens was correlated with better clinical prognosis for patients with primary ovarian cancers. For recurrent ovarian cancers, HIPEC only improved the OS but did not elicit significant value on the PFS. Electronic supplementary material The online version of this article (10.1186/s13048-019-0509-1) contains supplementary material, which is available to authorized users.

Hyperthermic intraperitoneal chemotherapy for ovarian cancer: The heat is on

“…Two prospective case-control studies concluded that the treatment was feasible and safe in the primary setting, but they were not able to draw conclusions on survival outcomes. 40 This meta-analysis confirms the finding in the OVHIPEC trial that the addition of HIPEC to surgery does not increase toxicity. 39 A recent meta-analysis including randomized controlled trials and case-control trials showed better outcomes after treatment with surgery and HIPEC in patients with primary advanced ovarian cancer (pooled HR for OS, 0.54; 95% CI, 0.45-0.66; pooled HR for PFS, 0.45; 95% CI, 0.32-0.62).…”

“…39 A recent meta-analysis including randomized controlled trials and case-control trials showed better outcomes after treatment with surgery and HIPEC in patients with primary advanced ovarian cancer (pooled HR for OS, 0.54; 95% CI, 0.45-0.66; pooled HR for PFS, 0.45; 95% CI, 0.32-0.62). 40 This meta-analysis confirms the finding in the OVHIPEC trial that the addition of HIPEC to surgery does not increase toxicity. 18,32,41 A Korean study group presented preliminary results of a randomized trial at the 2017 American Society of Clinical Oncology annual meeting.…”

Surgeons’ Ability to Predict the Extent of Surgery Prior to Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy

“…HIPEC has improved survival outcomes for patients with PM from various primary tumors. [1][2][3][4][5][6][7] This potential survival benefit needs to be in balance with the associated risks of treatment-related morbidity and mortality. HIPEC surgeons attempt to make this estimation for their patients in advance of planning a CRS ?…”

Quo Vadis Oncological Hyperthermia (2020)?

“…Various techniques are used to achieve local-regional hyperthermia (LRHT), all of which have the end goal of the destruction of the tumor. Techniques that have been developed to achieve this include: infrared water-window (IR-A); ( 61 , 62 ) Hyperthermic Intraperitoneal Chemotherapy ( 63 , 64 ), [HIPEC: heating the abdominal organs using a warm chemo solution applied during open surgery ( 65 ) or laparoscopic surgery ( 66 )] and High-intensity focused ultrasound [HIFU, for deep non-invasive heating ( 67 , 68 )]. Photodynamic therapy (PDT) and its different versions are local energy-absorption applications which use the activation of a photosensitizer by the appropriate light dose (usually using a laser-beam in a minimally invasive way) ( 69 ).…”