Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;9(4):1140-1148.
doi: 10.21037/gs-20-335.

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

Stefano Cianci  1 , Gaetano Riemma  1 , Carlo Ronsini  2 , Pasquale De Franciscis  1 , Marco Torella  1 , Antonio Schiattarella  1 , Marco La Verde  1 , Nicola Colacurci  1
Affiliations

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

Stefano Cianci et al. Gland Surg. 2020 Aug.

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.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-335). The series “Ovarian Cancer Recurrence” was commissioned by the editorial office without any funding or sponsorship. SC served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Gland Surgery from Aug 2019 to Jul 2021. The authors have no other conflicts of interest to declare.

Figures

Figure 1
Figure 1
Study selection search strategy.
Figure 2
Figure 2
One-year OS forest plot.
Figure 3
Figure 3
Two, 3, 5 years OS forest plot.
See this image and copyright information in PMC

References

    1. Leitao MM, Jr, Chi DS. Surgical management of recurrent ovarian cancer. Semin Oncol 2009;36:106-11. 10.1053/j.seminoncol.2008.12.002 - DOI - PubMed
    1. Tozzi R, Giannice R, Cianci S, et al. Neo-adjuvant chemotherapy does not increase the rate of complete resection and does not significantly reduce the morbidity of Visceral-Peritoneal Debulking (VPD) in patients with stage IIIC-IV ovarian cancer. Gynecol Oncol 2015;138:252-8. 10.1016/j.ygyno.2015.05.010 - DOI - PubMed
    1. Bristow RE, Tomacruz RS, Armstrong DK, et al. Survival effect of maximal cytoreductive surgery for advanced ovarian carcinoma during the platinum era: a meta-analysis. J Clin Oncol 2002;20:1248-59. 10.1200/JCO.2002.20.5.1248 - DOI - PubMed
    1. Paris I, Cianci S, Vizzielli G, et al. Upfront HIPEC and bevacizumab- containing adjuvant chemotherapy in advanced epithelial ovarian cancer. Int J Hyperthermia 2018;35:370-4. 10.1080/02656736.2018.1503346 - DOI - PubMed
    1. Issels RD. Hyperthermia adds to chemotherapy. Eur J Cancer 2008;44:2546-54. 10.1016/j.ejca.2008.07.038 - DOI - PubMed