(HealthDay News) — The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery is associated with improved outcomes in patients with stage III epithelial ovarian cancer, according to a study published in the Jan. 18 issue of the New England Journal of Medicine.
Willemien J. van Driel, MD, PhD, from the Netherlands Cancer Institute in Amsterdam, and colleagues conducted a multicenter, phase 3 trial involving 245 patients with at least stable stage III epithelial ovarian cancer after 3 cycles of carboplatin and paclitaxel. Patients were randomized to undergo interval cytoreductive surgery either with or without administration of HIPEC with cisplatin. Postoperatively, 3 additional carboplatin and paclitaxel cycles were administered.
The researchers found that 89 and 81% of patients who underwent cytoreductive surgery without HIPEC and with HIPEC, respectively, had events of disease recurrence or death in the intention-to-treat analysis (hazard ratio, 0.66). The median recurrence-free survival was 10.7 and 14.2 months in the surgery and surgery-plus-HIPEC groups, respectively; median overall survival was 33.9 and 45.7 months, respectively. At a median follow-up of 4.7 years, 62 and 50% of patients in the surgery and surgery-plus-HIPEC groups, respectively, had died (hazard ratio, 0.67).
“Among patients with stage III epithelial ovarian cancer, the addition of HIPEC to interval cytoreductive surgery resulted in longer recurrence-free survival and overall survival than surgery alone and did not result in higher rates of side effects,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.
- van Driel WJ, Koole SN, Sikorska K, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Eng J Med. 2018 Jan 18. doi: 10.1056/NEJMoa1708618