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Updated: Apr 6, 2026
Quantitation of Intra-peritoneal Ovarian Cancer Metastasis
Published on: July 18, 2016
Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer
Alexi A Wright1, Angel Cronin2, Dana E Milne2
1Alexi A. Wright, Angel Cronin, Dana E. Milne, Nancy L. Keating, Ursula A. Matulonis, and Jane C. Weeks, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA; Michael A. Bookman, University of Arizona Cancer Center, Tucson, AZ; Robert A. Burger, University of Pennsylvania; Gina Mantia-Smaldone, Fox Chase Cancer Center, Philadelphia, PA; David E. Cohn and David M. O'Malley, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Mihaela Cristea and Joyce C. Niland, City of Hope Comprehensive Cancer Center, Duarte, CA; Jennifer J. Griggs, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; and Charles F. Levenback and Larissa A. Meyer, The University of Texas MD Anderson Cancer Center, Houston, TX. alexi_wright@dfci.harvard.edu.
Purpose:
A 2006 randomized trial demonstrated a 16-month survival benefit with intraperitoneal and intravenous (IP/IV) chemotherapy administered to patients who had ovarian cancer, compared with IV chemotherapy alone, but more treatment-related toxicities. The objective of this study was to examine the use and effectiveness of IP/IV chemotherapy in clinical practice.
Patients And Methods:
Prospective cohort study of 823 women with stage III, optimally cytoreduced ovarian cancer diagnosed at six National Comprehensive Cancer Network institutions. We examined IP/IV chemotherapy use in all patients diagnosed between 2003 and 2012 (N = 823), and overall survival and treatment-related toxicities with Cox regression and logistic regression, respectively, in a propensity score-matched sample (n = 402) of patients diagnosed from 2006 to 2012, excluding trial participants, to minimize selection bias.
Results:
Use of IP/IV chemotherapy increased from 0% to 33% between 2003 and 2006, increased to 50% from 2007 to 2008, and plateaued thereafter. Between 2006 and 2012, adoption of IP/IV chemotherapy varied by institution from 4% to 67% (P < .001) and 43% of patients received modified IP/IV regimens at treatment initiation. In the propensity score-matched sample, IP/IV chemotherapy was associated with significantly improved overall survival (3-year overall survival, 81% v 71%; hazard ratio, 0.68; 95% CI, 0.47 to 0.99), compared with IV chemotherapy, but also more frequent alterations in chemotherapy delivery route (adjusted rates discontinuation or change, 20.4% v 10.0%; adjusted odds ratio, 2.83; 95% CI, 1.47 to 5.47).
Conclusion:
Although the use of IP/IV chemotherapy increased significantly at National Comprehensive Cancer Network centers between 2003 and 2012, fewer than 50% of eligible patients received it. Increasing IP/IV chemotherapy use in clinical practice may be an important and underused strategy to improve ovarian cancer outcomes.
