Upfront or intermediate treatment of advanced ovarian cancer patients with cytoreduction plus HIPEC: Results of a retrospective study

• Published in: Journal of surgical oncology Vol. 123; no. 2; pp. 630 - 637
• Main Authors: Spiliotis, John, Iavazzo, Christos, Fotiou, Alexandros, Kopanakis, Nikolaos, Terra, Alexios, Efstathiou, Elias, Margari, Charalambia, Tsiatas, Marinos
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2021
• Subjects: Adult; Aged; Aged, 80 and over; Chemotherapy; Combined Modality Therapy; Cytoreduction Surgical Procedures - mortality; Female; Follow-Up Studies; HIPEC; Humans; Hyperthermia, Induced - mortality; Hyperthermic Intraperitoneal Chemotherapy - mortality; intermediate; Male; Middle Aged; Neoadjuvant Therapy - mortality; Ovarian cancer; Ovarian Neoplasms - pathology; Ovarian Neoplasms - therapy; Prognosis; Retrospective Studies; Surgery; survival; Survival Rate; upfront; intermediate; HIPEC; upfront; ovarian cancer; survival
• ISSN: 0022-4790; 1096-9098; 1096-9098
• DOI: 10.1002/jso.26280

Background Newly diagnosed advanced‐stage ovarian cancer patients are treated with neoadjuvant chemotherapy, primary or intermediate cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy (HIPEC). The aim of this study is to evaluate the optimal timing of cytoreduction plus HIPEC for advanced ovarian cancer patients. Methods Advanced ovarian cancer patients treated with cytoreductive surgery plus HIPEC at three different hospitals between 2005 and 2019 were subgrouped regarding their time of management with cytoreduction plus HIPEC, upfront or intermediate. We retrospectively assessed the overall survival (OS), the progression‐free survival (PFS), and the disease‐free survival (DFS) of these groups. Results A total of 112 ovarian cancer patients were contained. Of whom, 47 patients were in the upfront group with 24 (51.1%) to be alive, while 65 patients were included in the intermediate group with 34 (52.3%) to be alive. OS (48 vs. 30 months) and DFS (42 vs. 20 months) indicated no significant difference. Although the same median PFS was observed in both groups (10 months), a higher mean PFS was observed in the upfront group (11.9 vs. 9 months, p = 0.023). Conclusion The treatment of advanced ovarian cancer patients with upfront cytoreductive surgery plus HIPEC is feasible with the same survival results. Further, larger prospective studies need to verify our results.