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
Review
. 2023 Nov 23;13(12):1636.
doi: 10.3390/jpm13121636.

Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis

Maria Teresa Climent  1   2 , Anna Serra  1   2 , Carolina Balaguer  3 , Antoni Llueca  1   2
Affiliations
Review

Should We Abandon Intraperitoneal Chemotherapy in the Treatment of Advanced Ovarian Cancer? A Meta-Analysis

Maria Teresa Climent et al. J Pers Med. .

Abstract

Background: Ovarian cancer is the gynaecological malignancy with the highest mortality and diagnosis often occurs in its advanced stages. Standard treatment in these cases is based on complete cytoreductive surgery with adjuvant intravenous chemotherapy. Other types of treatment are being evaluated to improve the prognosis of these patients, including intraperitoneal chemotherapy and antiangiogenic therapy. These may improve survival or time to relapse in addition to intravenous chemotherapy.

Objective: The aim of this meta-analysis is to determine whether treatment with intravenous chemotherapy remains the gold standard, or whether the addition of intraperitoneal chemotherapy has a benefit in overall survival (OS) and disease-free interval (DFS).

Materials and methods: A literature search was carried out in Pubmed and Cochrane, selecting clinical studies and systematic reviews published in the last 10 years. Statistical analysis was performed using the hazard ratio measure in the RevMan tool.

Results: Intraperitoneal chemotherapy shows a benefit in OS and DFS compared with standard intravenous chemotherapy. The significant differences in OS (HR: 0.81 CI 95% 0.74-0.88) and in DFS (HR: 0.81 CI 95% 0.75-0.87) are statistically significant (p < 0.00001). There were no clinical differences in toxicity and side-effects.

Conclusion: Intraperitoneal chemotherapy is an option that improves OS and DFS without significant toxicity regarding the use of intravenous chemotherapy alone. However, prospective studies are needed to determine the optimal dose and treatment regimen that will maintain the benefits while minimising side effects and toxicity and the profile of patients who will benefit most from this treatment.

Keywords: advanced ovarian cancer; disease-free survival; intraperitoneal chemotherapy; overall survival; primary cytorreductive surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA diagram showing the selection process of the articles included in the study.
Figure 2
Figure 2
Statistical study of OS: Results obtained from all studies included in the review [13,24,25,26,27,28].
Figure 3
Figure 3
Statistical study of DFS: Results obtained from all studies included except Wright 2015 [13,24,25,26,28].
Figure 4
Figure 4
Funnel plot studies included OS [13,24,25,26,27,28].
Figure 5
Figure 5
Funnel plot studies included DFS [13,24,25,26,28].
See this image and copyright information in PMC

References

    1. Torre L.A., Siegel R.L., Ward E.M., Jemal A. Global cancer incidence and mortality rates and trends—An update. Cancer Epidemiol. Biomark. Prev. 2016;25:16–27. doi: 10.1158/1055-9965.EPI-15-0578. - DOI - PubMed
    1. Ferlay J., Colombet M., Soerjomataram I., Parkin D.M., Piñeros M., Znaor A., Bray F. Cancer statistics for the year 2020: An overview. Int. J. Cancer. 2021;149:778–789. doi: 10.1002/ijc.33588. - DOI - PubMed
    1. Coleman R.L., Monk B.J., Sood A.K., Herzog T.J. Latest research and clinical treatment of advanced-stage epithelial ovarian cancer. Nat. Rev. Clin. Oncol. 2013;10:211. doi: 10.1038/nrclinonc.2013.5. - DOI - PMC - PubMed
    1. Chang S.J., Bristow R.E. Evolution of surgical treatment paradigms for advanced-stage ovarian cancer: Redefining ‘optimal’ residual disease. Gynecol. Oncol. 2012;125:483–492. doi: 10.1016/j.ygyno.2012.02.024. - DOI - PubMed
    1. Bookman M.A., Brady M.F., McGuire W.P., Harper P.G., Alberts D.S., Friedlander M., Colombo N., Fowler J.M., Argenta P.A., Geest K.D., et al. Evaluation of New Platinum-Based Treatment Regimens in Advanced-Stage Ovarian Cancer: A Phase III Trial of the Gynecologic Cancer InterGroup. J. Clin. Oncol. 2009;27:1419. doi: 10.1200/JCO.2008.19.1684. - DOI - PMC - PubMed

LinkOut - more resources