Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis

Stefano Cianci; Gaetano Riemma; Carlo Ronsini; Pasquale De Franciscis; Marco Torella; Antonio Schiattarella; Marco La Verde; Nicola Colacurci

doi:10.21037/gs-20-335

Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis

Gland Surg. 2020 Aug;9(4):1140-1148. doi: 10.21037/gs-20-335.

Authors

Stefano Cianci¹, Gaetano Riemma¹, Carlo Ronsini², Pasquale De Franciscis¹, Marco Torella¹, Antonio Schiattarella¹, Marco La Verde¹, Nicola Colacurci¹

Affiliations

¹ Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
² Gynecologic and Obstetrics Unit, Università "G. d'Annunzio", Chieti, Italy.

Abstract

Background: Ovarian cancer is the first cause of death among gynecological malignancies with a high incidence of recurrence. Different treatment options are suitable to prolong the survival rate of these patients. Over the last years, one of the most intriguing methods, adopted in different oncologic centers worldwide, is the hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods: A meta-analysis was performed to value the role of HIPEC for ovarian cancer recurrence. Search strategy was conducted with a combination of the following keywords: "ovarian recurrence, ovarian cancer recurrence, peritoneal cancer recurrence, ovarian recurrence AND HIPEC, secondary cytoreduction HIPEC". Seven studies were selected for analysis.

Results: In women with recurrent ovarian cancer (ROC), the use of HIPEC in addition to cytoreductive surgery and chemotherapy significantly improved 1-year overall survival (OS) when compared to protocols without HIPEC (OR 2.42; 95% CI, 1.06-5.56; P=0.04; I²=4%). The improvement in OS was maintained significant also after 2, 3 and 5 years respectively (OR 3.33; 95% CI, 1.81-6.10; P<0.01; I²=0%), (OR 4.22; 95% CI, 2.07-8.60; P<0.01; I²=52%), (OR 5.17; 95% CI, 1.40-19.09; P=0.01; I²=82%).

Conclusions: HIPEC seems to have an effective role to prolong survival in patients affected by ROC.

Keywords: Ovarian cancer; chemotherapy; hyperthermic intraperitoneal chemotherapy (HIPEC); loco-regional treatment; peritoneal carcinosis; recurrence.