What it’s about
In patients who have surgery to remove all visible ovarian cancer, the addition of heated chemotherapy directly into the abdomen for 90 minutes, improves survival. This heated chemotherapy is called ‘Hyperthermic intraperitoneal chemotherapy’ or HIPEC. Chemotherapy is most commonly delivered directly to the vein but an alternative way is to allow chemotherapy to come directly into contact with the cancer in the abdomen.
A total of 245 women were included in this study. All patients had received three cycles of intravenous (IV) chemotherapy. They then had surgery to remove all visible cancer in the abdomen, also called ‘interval cytoreductive’ surgery. In this trial, at the time of surgery to remove all visible disease, patients were divided into two groups. Group one had surgery only. Group two received heated IP chemotherapy (HIPEC) delivered directly into the abdomen after the surgery. The abdominal organs were ‘bathed’ in the chemotherapy for a total of 90 minutes. The chemotherapy was then removed. All patients in both groups received a further 3 cycles of intravenous chemotherapy after they recovered from their surgery.
This trial looked the length of time people survive without the cancer growing (progression free survival ‘PFS’) and at overall survival (OS) which is the length of time from diagnosis to death. The progression free survival of the HIPEC group was longer than the surgery alone group (surgery alone 10.7 months, HIPEC group 14.2 months). The overall survival in the HIPEC group was also longer. The median overall survival was 33.9 months in the surgery group and 45.7 months in the surgery-plus-HIPEC group. The addition of HIPEC did not increase complications or length of stay in hospital.
The addition of HIPEC after interval surgery for ovarian cancer improved progression free survival and overall survival.