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Updated: Jun 5, 2026
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Heterotypic Three-dimensional In Vitro Modeling of Stromal-Epithelial Interactions During Ovarian Cancer Initiation and Progression
Published on: August 28, 2012
Cytoreductive Surgery Plus HIPEC in Recurrent or Newly Diagnosed Advanced Epithelial Ovarian Cancer: a Meta-analysis
C Taliento1, S Restaino2,3, M Arcieri2
1Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Ferrara, Italy.
Annals of Surgical Oncology
|February 4, 2025
Summary
Hyperthermic intraperitoneal chemotherapy (HIPEC) combined with cytoreductive surgery improves progression-free survival in advanced ovarian cancer patients receiving neoadjuvant chemotherapy, but increases acute kidney failure risk.
Area of Science:
- Oncology
- Surgical Oncology
- Gynecologic Oncology
Background:
- Two randomized controlled trials (RCTs) in 2024 provided new evidence on hyperthermic intraperitoneal chemotherapy (HIPEC) for epithelial ovarian cancer (EOC).
- Updating progression-free survival (PFS) and adverse event data is crucial for understanding HIPEC's benefits and risks with cytoreductive surgery (CRS).
- HIPEC may be used with or without neoadjuvant chemotherapy (NACT) in EOC treatment.
Purpose of the Study:
- To evaluate the efficacy and safety of HIPEC in combination with CRS for epithelial ovarian cancer.
- To analyze the impact of HIPEC on progression-free survival (PFS) and adverse events in EOC patients.
- To compare HIPEC plus CRS versus CRS alone in different treatment settings.
Main Methods:
- An electronic literature search was performed across PubMed, Web of Science, EBSCO, and CENTRAL up to November 23, 2024.
- Included studies were RCTs reporting PFS and adverse events for interval or secondary CRS with or without HIPEC in newly diagnosed or recurrent EOC.
- A meta-analysis of six RCTs was conducted.
Main Results:
- HIPEC addition to surgery significantly improved PFS in newly diagnosed advanced-stage EOC patients who received NACT (HR 0.59; p = 0.01).
- No significant PFS difference was found for recurrent EOC without prior NACT between secondary CRS plus HIPEC and CRS alone (HR 1.22; p = 0.32).
- Decreased platelet count was more frequent with HIPEC (p = 0.03), and acute kidney failure (AKF) occurred in 10.6% of patients, significantly higher than with CRS alone (p = 0.003).
Conclusions:
- HIPEC combined with CRS significantly improves PFS in advanced EOC patients who received NACT.
- The addition of HIPEC to CRS is associated with a higher incidence of acute kidney failure (AKF), affecting 10.6% of patients.
- The findings highlight a trade-off between improved PFS and increased risk of AKF with HIPEC in specific EOC patient groups.
