Interval Cytoreductive Surgery and Cisplatin- or Paclitaxel-Based HIPEC for Advanced Ovarian Cancer.

Area of Science:

• Oncology
• Surgical Oncology
• Gynecologic Oncology

Background:

• Advanced ovarian cancer presents significant treatment challenges, often diagnosed at late stages.
• Hyperthermic intraperitoneal chemotherapy (HIPEC) is a critical treatment modality for advanced ovarian cancer.
• Evaluating different HIPEC regimens is essential for improving patient survival and outcomes.

Purpose of the Study:

• To compare the oncological outcomes of HIPEC with paclitaxel (HIPEC-paclitaxel) versus HIPEC with cisplatin (HIPEC-cisplatin) in advanced ovarian cancer patients undergoing interval cytoreductive surgery (iCRS).
• To determine if HIPEC-paclitaxel is a comparable alternative to HIPEC-cisplatin in terms of overall survival (OS) and disease-free survival (DFS).

Main Methods:

• A multicenter retrospective cohort study involving patients with advanced ovarian cancer who underwent iCRS and HIPEC.
• Utilized data from the National Registry of Peritoneal Carcinomatosis (27 Spanish centers) between January 2012 and December 2022.
• Employed propensity score matching to ensure comparability between the HIPEC-paclitaxel and HIPEC-cisplatin groups (199 patients each).

Main Results:

• The study included 846 patients, with 398 matched patients (199 per group) after propensity score matching.
• HIPEC-paclitaxel demonstrated similar disease-free survival (DFS) and overall survival (OS) compared to HIPEC-cisplatin.
• No significant difference in complication rates (morbidity) was observed between the two HIPEC regimens.

Conclusions:

• HIPEC-paclitaxel is an effective and comparable alternative to HIPEC-cisplatin for advanced ovarian cancer patients undergoing iCRS.
• This finding supports the use of HIPEC-paclitaxel, especially in patients for whom cisplatin may be contraindicated.
• Further research can help refine HIPEC protocols and personalize treatment for improved patient outcomes.