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Adding HIPEC to Cytoreductive Surgery Beneficial in Ovarian CA

WEDNESDAY, Jan. 17, 2018 -- 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, M.D., Ph.D., 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 three cycles of carboplatin and paclitaxel. Patients were randomized to undergo interval cytoreductive surgery either with or without administration of HIPEC with cisplatin. Postoperatively, three additional carboplatin and paclitaxel cycles were administered.

The researchers found that 89 and 81 percent 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 percent 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.

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Posted: January 2018