Prolonged survival in epithelial ovarian cancer patients: Efficacy and safety of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy

  • Xiaogang Lv Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou 511495, China
  • Wenjuan Wu Guangzhou Institute of Cancer Research, the Affiliated Cancer Hospital, Guangzhou Medical University, Guangzhou 511495, China
Keywords: epithelial ovarian cancer; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; overall survival
Article ID: 753

Abstract

Objective: To investigate the effects of Cytoreductive surgery (CRS) combined with Hyperthermic intraperitoneal chemotherapy (HIPEC) on the clinical efficacy and safety of Epithelial ovarian cancer (EOC) patients. Methods: We selected 120 EOC patients treated in the Affiliated Cancer Hospital of Guangzhou Medical University during July 2010 to July 2020 as retrospective case-control study subjects. They were divided into 60 cases in the observation group (CRS and HIPEC) and 60 cases in the comparison group (CRS) according to the principle of balanced clinicopathological characteristics. Adverse effects and prognosis-related factors, Overall survival (OS) and safety were analyzed in the two groups. Results: The results of multifactorial Cox regression analysis showed that CC score [P = 0.013, HR (95%CI) = 2.153 (1.014−7.638)], postoperative chemotherapy cycle [P = 0.045, HR (95%CI) = 2.056 (2.004−6.730)], and treatment method [P = 0.025, HR (95%CI) = 2.409 (1.000−5.814)], lymph node status P = 0.019, [HR (95%CI) = 1.221 (1.032−10.136)], and ascites volume P = 0.034, [HR (95%CI) = 2.459 (1.072−5.643)] were independent influences on overall survival. Conclusions: CRS and HIPEC prolonged overall survival in patients with recurrent EOC with a high safety profile.

References

1. Van Stein RM, Aalbers AGJ, Sonke GS, van Driel WJ. Hyperthermic Intraperitoneal Chemotherapy for Ovarian and Colorectal Cancer: A Review. JAMA Oncol. 2021 Aug 1;7(8):1231-1238. doi: 10.1001/jamaoncol.2021.0580. PMID: 33956063.

2. Koole S, van Stein R, Sikorska K, Barton D, Perrin L, Brennan D, Zivanovic O, Mosgaard BJ, Fagotti A, Colombo PE, Sonke G, Driel WJV; OVHIPEC-2 Steering Committee and the Dutch OVHIPEC group. Primary cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (HIPEC) for FIGO stage III epithelial ovarian cancer: OVHIPEC-2, a phase III randomized clinical trial. Int J Gynecol Cancer. 2020 Jun;30(6):888-892. doi: 10.1136/ijgc-2020-001231. Epub 2020 Mar 23. PMID: 32205449; PMCID: PMC8202725.

3. Aronson SL, Lopez-Yurda M, Koole SN, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, de Hingh IHJT, van Gent MDJM, Arts HJG, van Ham MAPC, van Dam PA, Vuylsteke P, Aalbers AGJ, Verwaal VJ, Van de Vijver KK, Aaronson NK, Sonke GS, van Driel WJ. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy in patients with advanced ovarian cancer (OVHIPEC-1): final survival analysis of a randomised, controlled, phase 3 trial. Lancet Oncol. 2023 Oct;24(10):1109-1118. doi: 10.1016/S1470-2045(23)00396-0. Epub 2023 Sep 11. PMID: 37708912.

4. Polom K, Roviello G, Generali D, Marano L, Petrioli R, Marsili S, Caputo E, Marrelli D, Roviello F. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for treatment of ovarian cancer. Int J Hyperthermia. 2016 May;32(3):298-310. doi: 10.3109/02656736.2016.1149233. Epub 2016 Mar 17. PMID: 26984715.

5. Souadka A, Essangri H, Majbar MA, Benkabbou A, Boutayeb S, You B, Glehen O, Mohsine R, Bakrin N. Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses. Front Oncol. 2022 May 9;12:809773. doi: 10.3389/fonc.2022.809773. PMID: 35615149; PMCID: PMC9124965.

6. Llueca M, Ibañez MV, Climent MT, Serra A, Llueca A; MUAPOS and OSRG Working Group. Effectiveness of Hyperthermic Intraperitoneal Chemotherapy Associated with Cytoreductive Surgery in the Treatment of Advanced Ovarian Cancer: Systematic Review and Meta-Analysis. J Pers Med. 2023 Jan 30;13(2):258. doi: 10.3390/jpm13020258. PMID: 36836494; PMCID: PMC9960788.

7. Klos D, Riško J, Hanuliak J, Neoral Č, Pilka R, Dzvinčuk P, Lemstrová R, Melichar B, Duchoňová-Mohelníková B. Peritoneal Carcinomatosis from Ovarian Cancer - Current Clinical Impact of Cytoreductive Surgery and Intraperitoneal Hyperthermic Chemotherapy. Klin Onkol. 2019 Fall;32(5):349-352. English. doi: 10.14735/amko2019349. PMID: 31610667.

8. Lee JY, Lee YJ, Son JH, Kim S, Choi MC, Suh DH, Song JY, Hong DG, Kim MK, Kim JH, Chang SJ. Hyperthermic Intraperitoneal Chemotherapy After Interval Cytoreductive Surgery for Patients With Advanced-Stage Ovarian Cancer Who Had Received Neoadjuvant Chemotherapy. JAMA Surg. 2023 Nov 1;158(11):1133-1140. doi: 10.1001/jamasurg.2023.3944. PMID: 37672264; PMCID: PMC10483378.

9. Huo YR, Richards A, Liauw W, Morris DL. Hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) in ovarian cancer: A systematic review and meta-analysis. Eur J Surg Oncol. 2015 Dec;41(12):1578-89. doi: 10.1016/j.ejso.2015.08.172. Epub 2015 Sep 25. PMID: 26453145.

10. Gelissen JH, Adjei NN, McNamara B, Mutlu L, Harold JA, Clark M, Altwerger G, Dottino PR, Huang GS, Santin AD, Azodi M, Ratner E, Schwartz PE, Andikyan V. Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer. Ann Surg Oncol. 2023 Sep;30(9):5597-5609. doi: 10.1245/s10434-023-13757-0. Epub 2023 Jun 26. PMID: 37358686.

11. Kim SI, Kim JH, Lee S, Cho H, van Driel WJ, Sonke GS, Bristow RE, Park SY, Fotopoulou C, Lim MC. Hyperthermic intraperitoneal chemotherapy for epithelial ovarian cancer: A meta-analysis. Gynecol Oncol. 2022 Dec;167(3):547-556. doi: 10.1016/j.ygyno.2022.10.010. Epub 2022 Oct 20. PMID: 36273925.

12. Lee D, Lee J, Park H, Lee YJ, Lee JY, Nam EJ, Kim SW, Kim S, Kim YT. Secondary cytoreductive surgery with and without hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer. Gland Surg. 2023 Dec 26;12(12):1696-1704. doi: 10.21037/gs-23-293. Epub 2023 Dec 22. PMID: 38229838; PMCID: PMC10788571.

13. Paquette B, Kalbacher E, Mercier F, Lakkis Z, Doussot A, Turco C, Caputo E, Pili-Floury S, Royer B, Mansi L, Delroeux D, Demarchi M, Pivot X, Chauffert B, Clement E, Heyd B. Cytoreductive Surgery and Intraperitoneal Chemotherapy in Advanced Serous Epithelial Ovarian Cancer: A 14-Year French Retrospective Single-Center Study of 124 Patients. Ann Surg Oncol. 2022 May;29(5):3322-3334. doi: 10.1245/s10434-021-11211-7. Epub 2022 Jan 7. PMID: 34994906.

14. Helm CW, Bristow RE, Kusamura S, Baratti D, Deraco M. Hyperthermic intraperitoneal chemotherapy with and without cytoreductive surgery for epithelial ovarian cancer. J Surg Oncol. 2008 Sep 15;98(4):283-90. doi: 10.1002/jso.21083. PMID: 18726895.

15. Aronson SL, Sonke GS, van Driel WJ. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy in advanced ovarian cancer - Authors' reply. Lancet Oncol. 2023 Dec;24(12):e458. doi: 10.1016/S1470-2045(23)00588-0. PMID: 38040000.

16. Praiss AM, Zhou Q, Iasonos A, Moukarzel L, Dessources K, Soldan K, Su K, Sonoda Y, Roche KL, Gardner GJ, Troso-Sandoval T, Tew WP, Grisham RN, Chi DS, O'Cearbhaill RE, Zivanovic O. Morbidity after secondary cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for ovarian cancer: An analysis of a randomized phase II trial. Gynecol Oncol. 2023 Apr;171:23-30. doi: 10.1016/j.ygyno.2023.02.003. Epub 2023 Feb 16. PMID: 36804618; PMCID: PMC10206782.

17. Llueca A, Ibañez MV, Cascales P, Gil-Moreno A, Bebia V, Ponce J, Fernandez S, Arjona-Sanchez A, Muruzabal JC, Veiga N, Diaz-Feijoo B, Celada C, Gilabert-Estelles J, Aghababyan C, Lacueva J, Calero A, Segura JJ, Maiocchi K, Llorca S, Villarin A, Climent MT, Delgado K, Serra A, Gomez-Quiles L, Llueca M, On Behalf Of Spain Gog And Gecop Working Group. Neoadjuvant Chemotherapy plus Interval Cytoreductive Surgery with or without Hyperthermic Intraperitoneal Chemotherapy (NIHIPEC) in the Treatment of Advanced Ovarian Cancer: A Multicentric Propensity Score Study. Cancers (Basel). 2023 Aug 26;15(17):4271. doi: 10.3390/cancers15174271. PMID: 37686547; PMCID: PMC10486645.

18. Brault C, Brind'Amour A, de Guerke L, Auclair MH, Sideris L, Dubé P, Soucisse M, Tremblay JF, Bernard L, Piedimonte S, Fortin S. Combined Interval Cytoreductive Surgery and Carboplatin-Based Hyperthermic Intraperitoneal Chemotherapy in Advanced Primary High-Grade Serous Ovarian Cancer. Curr Oncol. 2023 Dec 1;30(12):10272-10282. doi: 10.3390/curroncol30120748. PMID: 38132382; PMCID: PMC10742627.

19. Kim SI, Kim JW. Role of surgery and hyperthermic intraperitoneal chemotherapy in ovarian cancer. ESMO Open. 2021 Jun;6(3):100149. doi: 10.1016/j.esmoop.2021.100149. Epub 2021 May 10. PMID: 33984680; PMCID: PMC8314869.

20. Qi Y, Zhang Y, Shi Y, Yao S, Dai M, Cai H. Cytoreductive Surgery (CRS) Combined With Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Platinum-Sensitive Recurrence Epithelial Ovarian Cancer With HRR Mutation: A Phase III Randomized Clinical Trial. Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221104565. doi: 10.1177/15330338221104565. PMID: 35929135; PMCID: PMC9358559.

21. Conley AB, Fournier KF, Sood AK, Frumovitz M. Secondary Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy for Advanced or Recurrent Mucinous Ovarian Cancer. Obstet Gynecol. 2023 May 1;141(5):1019-1023. doi: 10.1097/AOG.0000000000005154. Epub 2023 Apr 5. PMID: 37023452.

22. Saladino E, Fleres F, Irato S, Famulari C, Macrì A. The role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of ovarian cancer relapse. Updates Surg. 2014 Jun;66(2):109-13. doi: 10.1007/s13304-013-0229-9. Epub 2013 Aug 27. PMID: 23980020.

23. Mutlu Sütcüoğlu B, Sütcüoğlu O. Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy in advanced ovarian cancer. Lancet Oncol. 2023 Dec;24(12):e457. doi: 10.1016/S1470-2045(23)00471-0. PMID: 38039999.

24. Carboni F, Federici O, Sperduti I, Zazza S, Sergi D, Corona F, Valle M. Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Epithelial Ovarian Cancer: A 20-Year Single-Center Experience. Cancers (Basel). 2021 Jan 29;13(3):523. doi: 10.3390/cancers13030523. PMID: 33572964; PMCID: PMC7866406.

25. Chen WC, Huang HJ, Yang LY, Pan YB, Huang KG, Lin CT, Chen MY, Tang YH, Chang TC, Lai CH, Chou HH. Hyperthermic intraperitoneal chemotherapy for recurrent epithelial ovarian cancer. Biomed J. 2022 Oct;45(5):821-827. doi: 10.1016/j.bj.2021.10.003. Epub 2021 Oct 14. PMID: 34656802; PMCID: PMC9661499.

26. Ghirardi V, Ronsini C, Trozzi R, Di Ilio C, Di Giorgio A, Cianci S, Draisci G, Scambia G, Fagotti A. Hyperthermic intraperitoneal chemotherapy in interval debulking surgery for advanced epithelial ovarian cancer: A single-center, real-life experience. Cancer. 2020 Dec 15;126(24):5256-5262. doi: 10.1002/cncr.33167. Epub 2020 Sep 15. PMID: 32931024.

27. Gajarawala S, Pelkowski J, Dorian R, Stanton A, Dinh T. Hyperthermic intraperitoneal chemotherapy for treating ovarian cancer. JAAPA. 2021 Aug 1;34(8):50-53. doi: 10.1097/01.JAA.0000735800.98948.bb. PMID: 34320542.

28. Van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, de Hingh IHJT, van der Velden J, Arts HJ, Massuger LFAG, Aalbers AGJ, Verwaal VJ, Kieffer JM, Van de Vijver KK, van Tinteren H, Aaronson NK, Sonke GS. Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer. N Engl J Med. 2018 Jan 18;378(3):230-240. doi: 10.1056/NEJMoa1708618. PMID: 29342393.

29. Lim MC, Chang SJ, Park B, Yoo HJ, Yoo CW, Nam BH, Park SY; HIPEC for Ovarian Cancer Collaborators. Survival After Hyperthermic Intraperitoneal Chemotherapy and Primary or Interval Cytoreductive Surgery in Ovarian Cancer: A Randomized Clinical Trial. JAMA Surg. 2022 May 1;157(5):374-383. doi: 10.1001/jamasurg.2022.0143. PMID: 35262624; PMCID: PMC8908225.

Published
2024-12-20
How to Cite
Lv, X., & Wu, W. (2024). Prolonged survival in epithelial ovarian cancer patients: Efficacy and safety of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. Molecular & Cellular Biomechanics, 21(4), 753. https://doi.org/10.62617/mcb753
Section
Article