TY - JOUR
T1 - Selection of patients with ovarian cancer who may show survival benefit from hyperthermic intraperitoneal chemotherapy
T2 - A systematic review and meta-analysis
AU - Kim, Se Ik
AU - Cho, Jaehyun
AU - Lee, Eun Ji
AU - Park, Sunwoo
AU - Park, Soo Jin
AU - Seol, Aeran
AU - Lee, Nara
AU - Yim, Ga Won
AU - Lee, Maria
AU - Lim, Whasun
AU - Song, Gwonhwa
AU - Chang, Suk Joon
AU - Kim, Jae Won
AU - Kim, Hee Seung
N1 - Publisher Copyright:
Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2019
Y1 - 2019
N2 - Background:The use of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery has been extensively studied in patients with peritoneal carcinomatosis from various malignancies. However, the effectiveness of HIPEC for ovarian cancer is still controversial. Therefore, we performed this meta-analysis to identify patients with ovarian cancer who can obtain survival benefit from HIPEC.Methods:Articles regarding HIPEC in the MEDLINE, EMBASE, and Cochrane Library were searched till December 2018. In total, 13 case-control studies and two randomized controlled trials were included in this meta-analysis. We investigated the effect of HIPEC on disease-free survival (DFS) and overall survival (OS), and performed subgroup analyses based on the study design, adjustment of confounding variables, and quality of the study.Results:HIPEC improved both DFS (hazard ratio [HR], 0.603; 95% confidence interval [CI], 0.513-0.709) and OS (HR, 0.640; 95% CI, 0.519-0.789). In cases of primary disease, HIPEC improved DFS (HR, 0.580; 95% CI, 0.476-0.706) and OS (HR, 0.611; 95% CI, 0.376-0.992). Subgroup analyses revealed that HIPEC did not improve OS but improved DFS of patients with residual tumors ≤1cm or no visible tumors. In cases of recurrent disease, HIPEC was associated with better OS (HR, 0.566; 95% CI, 0.379-0.844) but not with DFS. Subgroup analyses also revealed similar tendencies. However, HIPEC improved DFS of patients with residual tumors ≤1cm or no visible tumors, while it improved OS of only those with residual tumors ≤1cm.Conclusions:HIPEC may improve DFS of patients with ovarian cancer when residual tumors were ≤1cm or not visible. It may also improve OS of only patients with recurrent disease whose residual tumors were ≤1cm.
AB - Background:The use of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery has been extensively studied in patients with peritoneal carcinomatosis from various malignancies. However, the effectiveness of HIPEC for ovarian cancer is still controversial. Therefore, we performed this meta-analysis to identify patients with ovarian cancer who can obtain survival benefit from HIPEC.Methods:Articles regarding HIPEC in the MEDLINE, EMBASE, and Cochrane Library were searched till December 2018. In total, 13 case-control studies and two randomized controlled trials were included in this meta-analysis. We investigated the effect of HIPEC on disease-free survival (DFS) and overall survival (OS), and performed subgroup analyses based on the study design, adjustment of confounding variables, and quality of the study.Results:HIPEC improved both DFS (hazard ratio [HR], 0.603; 95% confidence interval [CI], 0.513-0.709) and OS (HR, 0.640; 95% CI, 0.519-0.789). In cases of primary disease, HIPEC improved DFS (HR, 0.580; 95% CI, 0.476-0.706) and OS (HR, 0.611; 95% CI, 0.376-0.992). Subgroup analyses revealed that HIPEC did not improve OS but improved DFS of patients with residual tumors ≤1cm or no visible tumors. In cases of recurrent disease, HIPEC was associated with better OS (HR, 0.566; 95% CI, 0.379-0.844) but not with DFS. Subgroup analyses also revealed similar tendencies. However, HIPEC improved DFS of patients with residual tumors ≤1cm or no visible tumors, while it improved OS of only those with residual tumors ≤1cm.Conclusions:HIPEC may improve DFS of patients with ovarian cancer when residual tumors were ≤1cm or not visible. It may also improve OS of only patients with recurrent disease whose residual tumors were ≤1cm.
KW - hyperthermic intraperitoneal chemotherapy
KW - meta-analysis
KW - ovarian cancer
UR - http://www.scopus.com/inward/record.url?scp=85077006614&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000018355
DO - 10.1097/MD.0000000000018355
M3 - Review article
C2 - 31852138
AN - SCOPUS:85077006614
SN - 0025-7974
VL - 98
JO - Medicine (United States)
JF - Medicine (United States)
IS - 50
M1 - e18355
ER -