HIPEC treatment in advanced and recurrent ovarian cancer: a meta-analysis of observational studies

This meta analysis summarizes survival outcomes of advanced and recurrent ovarian cancer patients undergoing hyperthermic intraperitoneal chemotherapy (HIPEC), from published studies between 1990 and 2015. Objective: The authors performed a meta-analysis on outcomes of patients with advanced (primary) and recurrent epithelial ovarian cancer (EOC) treated with cytoreductive surgery and HIPEC. Materials and Methods: Studies evaluating HIPEC in EOC patients published between January 1, 1990 and January 1, 2015 were identified using PubMed. Eligible studies had ≥ 10 patients and reported overall survival (OS). The authors performed multivariate analysis of OS and progression-free survival (PFS) based on modeling the point estimates with weighted fixed effects models. Results: Twenty-six studies met criteria with extractable statistics (n=1608): 13 advanced (n=534) and 14 recurrent EOC (n=1074). For primary advanced EOC, five-year OS was 39.7% (95% CI: 37.8-41.7%), with a 63-month median OS. For recurrent EOC, five-year OS was 32.0% (95% CI: 30.3-33.7%), with a 39-month median OS. Optimal cytoreduction was achieved in 79% of advanced and 77% of recurrent EOC patients. Mortality was 1.4% (advanced) and 3.9% (recurrent). Conclusions: HIPEC treatment in ovarian cancer in the primary or recurrent setting has favorable survival outcomes as compared to surgical cytoreduction alone, with comparable mortality rates.

Hyperthermic intraperitoneal chemotherapy; Ovarian cancer; Meta-analysis.

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