Addition of Hyperthermic Intraperitoneal Chemotherapy to Interval Cytoreductive Surgery in Advanced Ovarian Cancer

Final Survival Analysis of OVHIPEC-1 Trial

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As reported in The Lancet Oncology by Aronson et al, the final survival analysis of the Dutch-Belgian phase III OVHIPEC-1 trial showed that the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery was associated with maintained progression-free and overall survival benefits at 10 years in patients with advanced ovarian cancer.

Study Details

The open-label trial included 245 patients with primary epithelial stage III ovarian cancer from eight HIPEC centers in the Netherlands and Belgium who were not eligible for primary cytoreduction. They were randomly assigned between April 2007 and April 2016 to undergo interval cytoreductive surgery plus HIPEC with cisplatin at 100 mg/m² (n = 122) or interval cytoreductive surgery alone (n = 123). Patients had not progressed during at least three cycles of neoadjuvant carboplatin plus paclitaxel. In an analysis at 4.7 years of follow-up, patients in the HIPEC group had significantly better progression-free and overall survival.

Key Findings

Median follow-up at the time of final analysis was 10.4 years (95% confidence interval [CI] = 9.5–13.3 years) in the surgery/HIPEC group and 10.1 years (95% CI = 8.4–12.9 years) in the surgery alone group.

Median progression-free survival was 14.3 months (95% CI = 12.0–18.5 months) in the surgery/HIPEC group vs 10.7 months (95% CI = 9.6–12.0 months) in the surgery alone group (hazard ratio [HR] = 0.63, 95% CI = 0.48–0.83, P = .0008). Rates at 5 and 10 years were 12.3% vs 6.6% and 10.1% vs 6.6%, respectively.

Median overall survival was 44.9 months (95% CI = 38.6–55.1 months) in the surgery/HIPEC group vs 33.3 months (95% CI = 29.0–39.1 months) in the surgery alone group (HR = 0.70, 95% CI = 0.53–0.92, P = .011). Rates at 5 and 10 years were 36.9% vs 19.7% and 16.1% vs 10.9%, respectively.

The investigators concluded, “These updated survival results confirm the long-term survival benefit of HIPEC in patients with primary stage III epithelial ovarian cancer undergoing interval cytoreductive surgery.”

Willemien J. van Driel, MD, PhD, of the Department of Gynecologic Oncology, Netherlands Cancer Institute, Amsterdam, is the corresponding author for The Lancet Oncology article.

Disclosure: The study was funded by the Dutch Cancer Foundation. For full disclosures of the study authors, visit

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