Y R Huo1, A Richards2, W Liauw3, D L Morris4. 1. Department of Surgery, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia. 2. St George Clinical School, University of New South Wales, Sydney, NSW, Australia. 3. Cancer Care Centre, St George Hospital, Kogarah, Sydney, NSW 2217, Australia. 4. Department of Surgery, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia. Electronic address: david.morris@unsw.edu.au.
Abstract
PURPOSE: Emerging evidence suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) shows a survival benefit over CRS alone for patients with epithelial ovarian carcinoma (EOC). This systematic review and meta-analysis will assess the safety and efficacy of HIPEC with CRS for EOC. DESIGN: Searches of five databases from inception to 17/02/15 was performed. Clinical outcomes were synthesised, with full tabulation of results. RESULTS: A total of 9 comparative studies and 28 studies examining HIPEC + CRS for primary and/or recurrent EOC were included. Meta-analysis of the comparative studies showed HIPEC + CRS + chemotherapy had significantly better 1-year survival compared with CRS + chemotherapy alone (OR: 3.76, 95% CI 1.81-7.82). The benefit of HIPEC + CRS continued for 2-, 3-, 4-, 5- and 8-year survival compared to CRS alone (OR: 2.76, 95% CI 1.71-4.26; OR: 5.04, 95% CI 3.24-7.85; OR: 3.51, 95% CI 2.00-6.17; OR: 3.46 95% CI 2.19-5.48; OR: 2.42, 95% 1.38-4.24, respectively). Morbidity and mortality rates were similar. Pooled analysis of all studies showed that among patients with primary EOC, the median, 1-, 3-, and 5-year overall survival rates are 46.1 months, 88.2%, 62.7% and 51%. For recurrent EOC, the median, 1-, 3-, and 5-year overall survival rates are 34.9 months, 88.6%, 64.8% and 46.3%. A step-wise positive correlation between completeness of cytoreduction and survival was found. CONCLUSION: The addition of HIPEC to CRS and chemotherapy improves overall survival rates for both primary and recurrent EOC.
PURPOSE: Emerging evidence suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) shows a survival benefit over CRS alone for patients with epithelial ovarian carcinoma (EOC). This systematic review and meta-analysis will assess the safety and efficacy of HIPEC with CRS for EOC. DESIGN: Searches of five databases from inception to 17/02/15 was performed. Clinical outcomes were synthesised, with full tabulation of results. RESULTS: A total of 9 comparative studies and 28 studies examining HIPEC + CRS for primary and/or recurrent EOC were included. Meta-analysis of the comparative studies showed HIPEC + CRS + chemotherapy had significantly better 1-year survival compared with CRS + chemotherapy alone (OR: 3.76, 95% CI 1.81-7.82). The benefit of HIPEC + CRS continued for 2-, 3-, 4-, 5- and 8-year survival compared to CRS alone (OR: 2.76, 95% CI 1.71-4.26; OR: 5.04, 95% CI 3.24-7.85; OR: 3.51, 95% CI 2.00-6.17; OR: 3.46 95% CI 2.19-5.48; OR: 2.42, 95% 1.38-4.24, respectively). Morbidity and mortality rates were similar. Pooled analysis of all studies showed that among patients with primary EOC, the median, 1-, 3-, and 5-year overall survival rates are 46.1 months, 88.2%, 62.7% and 51%. For recurrent EOC, the median, 1-, 3-, and 5-year overall survival rates are 34.9 months, 88.6%, 64.8% and 46.3%. A step-wise positive correlation between completeness of cytoreduction and survival was found. CONCLUSION: The addition of HIPEC to CRS and chemotherapy improves overall survival rates for both primary and recurrent EOC.
Authors: Mustafa Raoof; Gautam Malhotra; Adrian Kohut; Michael O'Leary; Paul Frankel; Thuy Tran; Marwan Fakih; Joseph Chao; Dean Lim; Yanghee Woo; Isaac B Paz; Michael Lew; Mihaela C Cristea; Lorna Rodriguez-Rodriguez; Yuman Fong; Andrew Blakely; Richard Whelan; Marc A Reymond; Amit Merchea; Thanh H Dellinger Journal: Ann Surg Oncol Date: 2021-08-13 Impact factor: 5.344
Authors: Stefano Cianci; Gaetano Riemma; Carlo Ronsini; Pasquale De Franciscis; Marco Torella; Antonio Schiattarella; Marco La Verde; Nicola Colacurci Journal: Gland Surg Date: 2020-08