Jan B Vermorken1,2, Peter van Dam3,2, Alison Brand4,5. 1. Department of Medical Oncology. 2. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. 3. Department of Gynecologic Oncology, Antwerp University Hospital, Edegem. 4. Department of Gynecological Oncology, Westmead Hospital. 5. Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Abstract
PURPOSE OF REVIEW: The randomized OVHIPEC study provided further evidence that adding heated intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery significantly improved recurrence-free and overall survival in stage III epithelial ovarian cancer (EOC) patients, who were ineligible for primary cytoreductive surgery due to extensive intraperitoneal disease. Because opinions have been divided as to whether HIPEC is now a new standard of care for advanced EOC, the pros and cons of this approach are examined. A comparison with the ongoing discussion about the role of intraperitoneal chemotherapy is made. RECENT FINDINGS: For both techniques, experience is crucial and a learning curve essential. Compared with intraperitoneal chemotherapy, intraoperative application of HIPEC provides superior distribution through the peritoneal cavity. HIPEC, as given in OVHIPEC, did not significantly increase adverse events, had no negative effect on quality of life and was cost-effective. SUMMARY: Despite the ongoing debate about HIPEC, an important first step in attempting to demonstrate the efficacy of HIPEC in the first-line setting has been made with OVHIPEC. Critics have been of value to optimize future trials with HIPEC in patients with EOC.
PURPOSE OF REVIEW: The randomized OVHIPEC study provided further evidence that adding heated intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery significantly improved recurrence-free and overall survival in stage III epithelial ovarian cancer (EOC) patients, who were ineligible for primary cytoreductive surgery due to extensive intraperitoneal disease. Because opinions have been divided as to whether HIPEC is now a new standard of care for advanced EOC, the pros and cons of this approach are examined. A comparison with the ongoing discussion about the role of intraperitoneal chemotherapy is made. RECENT FINDINGS: For both techniques, experience is crucial and a learning curve essential. Compared with intraperitoneal chemotherapy, intraoperative application of HIPEC provides superior distribution through the peritoneal cavity. HIPEC, as given in OVHIPEC, did not significantly increase adverse events, had no negative effect on quality of life and was cost-effective. SUMMARY: Despite the ongoing debate about HIPEC, an important first step in attempting to demonstrate the efficacy of HIPEC in the first-line setting has been made with OVHIPEC. Critics have been of value to optimize future trials with HIPEC in patients with EOC.
Authors: Thanh H Dellinger; Ernest S Han; Mustafa Raoof; Byrne Lee; Xiwei Wu; Hyejin Cho; Ting-Fang He; Peter Lee; Marianne Razavi; Winnie S Liang; Daniel Schmolze; Saul J Priceman; Stephen Lee; Wei-Chien Lin; Jeff F Lin; Mehdi Kebria; Amy Hakim; Nora Ruel; Daphne B Stewart; Edward W Wang; Benjamin I Paz; Mark T Wakabayashi; Mihaela C Cristea; Lorna Rodriguez-Rodriguez Journal: JCO Precis Oncol Date: 2022-03