Abstract
Background and objectivePrevious studies about the prognostic value of the HIPEC have yielded controversial results. Therefore, this study aims to assess the impact of HIPEC on patients with ovarian cancer.ResultsWe included 13 comparative studies, and found that the overall survival (OS) and progression-free survival (PFS) in HIPEC groups were superior to groups without HIPEC treatment in the all total population (HR = 0.54,95% CI:0.45 to 0.66, HR = 0.45, 95% CI: 0.32 to 0.62). Additionally, the subgroup analysis showed that patients with advanced primary ovarian cancers also gained improved OS and PFS benefit from HIPEC (HR = 0.59,95% CI:0.46 to 0.75, HR = 0.41,95% CI:0.32 to 0.54). With regard to recurrent ovarian cancer, HIPEC was associated with improved OS (HR = 0.45,95% CI:0.24 to 0.83), but for the PFS, no correlation was observed between HIPC group and the non-HIPEC group (HR = 0.55,95% CI:0.27 to 1.11). HIPEC also led to favorable clinical outcome (HR = 0.64,95% CI:0.50 to 0.82, HR = 0.36,95% CI:0.20 to 0.65) for stage III or IV ovarian cancer with initial diagnosis.ConclusionThe review indicated that HIPEC-based regimens was correlated with better clinical prognosis for patients with primary ovarian cancers. For recurrent ovarian cancers, HIPEC only improved the OS but did not elicit significant value on the PFS.
Highlights
Ovarian cancer(OC) is one of the most lethal gynecologic cancers with 22,440 new cases and 14,080 deaths anticipated by 2017 in the United States [1]
In 2015, a published meta-analysis suggested that the Cytoreductive surgery (CRS) + hyperthermic intraperitoneal chemotherapy (HIPEC) +chemotherapy significantly improved 5-year overall survival rate compared to CRS + chemotherapy alone for the patients with primary ovarian cancer, but not for recurrent ovarian cancer [12]
The previous meta-analysis had revealed the association between HIPEC and better clinical prognosis, the positive effect was only applicable to the primary advanced ovarian cancer
Summary
Ovarian cancer(OC) is one of the most lethal gynecologic cancers with 22,440 new cases and 14,080 deaths anticipated by 2017 in the United States [1]. The development of surgery and chemotherapy improved clinical outcomes of patients with advanced ovarian cancer, the 5-year survival rate of less than 30% was still difficult to overcome. In contrast to IP chemotherapy without hyperthermia condition, HIPEC had following advantages 1) direct impairment against cancer cells 2) enhancement of the cytotoxicity of chemotherapy 3) inhibition of angiogenesis 4) improvement in denaturation of proteins 5) great tolerance without additional adverse effect [7–11] .due to the controversial impact of HIPEC for ovarian cancers, the role of HIPEC in the treatment of ovarian cancer is still debated. In 2015, a published meta-analysis suggested that the CRS + HIPEC +chemotherapy significantly improved 5-year overall survival rate compared to CRS + chemotherapy alone for the patients with primary ovarian cancer, but not for recurrent ovarian cancer [12]. This study aims to assess the impact of HIPEC on patients with ovarian cancer
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