Neoadjuvant Chemotherapy Following Hyperthermic Intraperitoneal Chemotherapy in Platinum-Sensitive Recurrent Ovarian...

Area of Science:

• Gynecologic Oncology
• Surgical Oncology
• Medical Oncology

Background:

• Platinum-sensitive recurrent ovarian cancer presents a therapeutic challenge.
• Optimizing treatment strategies for recurrent ovarian cancer is crucial for improving patient survival.

Purpose of the Study:

• To compare the efficacy of neoadjuvant chemotherapy (NACT) followed by secondary cytoreductive surgery (SCS) and hyperthermic intraperitoneal chemotherapy (HIPEC) versus SCS with HIPEC alone.
• To evaluate survival outcomes and safety in patients with platinum-sensitive recurrent ovarian cancer.

Main Methods:

• Retrospective analysis of 86 patients with platinum-sensitive recurrent ovarian cancer.
• Comparison of two cohorts: NACT + SCS + HIPEC versus SCS + HIPEC alone.
• Primary endpoint: progression-free survival (PFS); Secondary endpoints: overall survival (OS), safety.

Main Results:

• The SCS with HIPEC alone group had significantly longer PFS (20 months vs. 12 months) and OS (88 months vs. 34 months) compared to the NACT group.
• The NACT group experienced longer surgical times, higher transfusion needs, and more severe complications.
• No significant benefit was observed with the addition of NACT.

Conclusions:

• Neoadjuvant chemotherapy prior to SCS and HIPEC does not improve survival in platinum-sensitive recurrent ovarian cancer.
• SCS with HIPEC alone is associated with superior PFS and OS, highlighting the need for careful patient selection.
• Treatment strategies should be individualized to optimize outcomes in recurrent ovarian cancer.