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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2015

01-05-2015 | Gynecologic Oncology

Cytoreductive Surgery and HIPEC in Recurrent Epithelial Ovarian Cancer: A Prospective Randomized Phase III Study

Authors: J. Spiliotis, MD, PhD, E. Halkia, MD, PhD, E. Lianos, MD, N. Kalantzi, MD, A. Grivas, MD, E. Efstathiou, MD, S. Giassas, MD

Published in: Annals of Surgical Oncology | Issue 5/2015

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Abstract

Background

The current treatment of ovarian cancer consists of cytoreductive surgery (CRS) and systemic chemotherapy. The aim of this study was to examine if hyperthermic intraperitoneal chemotherapy (HIPEC) is an alternative modality to treat this category of patients along with a second attempt of surgical resection and second- or third-line systemic chemotherapy afterward.

Methods

In an 8-year period (2006–2013), 120 women with advanced ovarian cancer (International Federation of Gynecology and Obstetrics [FIGO] IIIc and IV) who experienced disease recurrence after initial treatment with conservative or debulking surgery and systemic chemotherapy were randomized into two groups. Group A comprised 60 patients treated with CRS followed by HIPEC and then systemic chemotherapy. Group B comprised 60 patients treated with CRS only and systemic chemotherapy.

Results

The mean survival for group A was 26.7 versus 13.4 months in group B (p < 0.006). Three-year survival was 75 % for group A versus 18 % for group B (p < 0.01). In the HIPEC group, the mean survival was not different between patients with platinum-resistant disease versus platinum-sensitive disease (26.6 vs. 26.8 months). On the other hand, in the non-HIPEC group, there was a statistically significant difference between platinum-sensitive versus platinum-resistant disease (15.2 vs. 10.2 months, p < 0.002). Complete cytoreduction was associated with longer survival. Patients with a peritoneal cancer index score of <15 appeared also to have longer survival.

Conclusions

The use of HIPEC along with the extent of the disease and the extent of cytoreduction play an important role in the survival of patients with recurrence in an initially advanced ovarian cancer.
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Metadata
Title
Cytoreductive Surgery and HIPEC in Recurrent Epithelial Ovarian Cancer: A Prospective Randomized Phase III Study
Authors
J. Spiliotis, MD, PhD
E. Halkia, MD, PhD
E. Lianos, MD
N. Kalantzi, MD
A. Grivas, MD
E. Efstathiou, MD
S. Giassas, MD
Publication date
01-05-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 5/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4157-9

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