A research team at the National Cancer Center (NCC) has found that applying hyperthermic intraperitoneal chemotherapy (HIPEC) after interval cytoreductive surgery can increase the survival rate of ovarian cancer patients.
Ovarian cancer has the highest mortality rate among gynecological cancers despite various treatments such as chemotherapy, targeted therapy, and immunotherapy after surgery. Even if hospitals apply appropriate treatment, 50-80 percent of patients with advanced ovarian cancer can experience recurrence.
For patients with advanced or recurrent ovarian cancer, hospitals can perform HIPEC according to the patient's condition to increase the therapeutic effect. HIPEC is a treatment that circulates a high-temperature anticancer agent directly into the abdominal cavity for about 90 minutes to remove any remaining cancer cells after surgically removing the cancer site seen with the naked eye.
The team, led by Professors Im Myung-chul and Park Sang-yoon, also confirmed that it is possible to improve the survival rate of ovarian cancer in patients with advanced ovarian cancer by performing HIPEC followed by interval cytoreductive surgery after prior chemotherapy.
The research team performed HIPEC in women with stage 3 or 4 advanced ovarian cancer after surgery if the residual tumor was less than 1 centimeter.
Among patients with stage 3 and 4 ovarian cancer who underwent interval cytoreductive surgery after prior chemotherapy, when the team performed HIPEC, the median progression-free survival increased from 15.4 months to 17.4 months, and the median overall survival from 48.2 months to 61.8 months.
The hazard ratios for recurrence or death were 0.60 (reduced risk of recurrence by 40 percent) and 0.53 (reduced risk of death by 47 percent), confirming that the prognosis of patients treated with HIPEC improved.
"We obtained a significant result through the study that showed that the low-cost HIPEC procedure improves the survival rate without lowering the quality of life," Professor Park said. "Notably, it is encouraging to see an increase in long-term survival rates."
The team expects HIPEC to improve treatment outcomes when interval cytoreductive surgery is performed among patients with advanced ovarian cancer, Park added.
Professor Im also said, "To increase the therapeutic effect of ovarian cancer patients with HIPEC, we are conducting global studies and actual clinical application."
Im noted that the team plans to conduct a randomized clinical study for platinum-resistant recurrent ovarian cancer and a clinical study to confirm the usefulness of HIPEC in patients with stage 4 and high-risk stage 3 ovarian cancers soon.
"Even with the new poly ADP-ribose polymerase (PARP) inhibitors, recurrence occurs in about 50 percent of patients," Im said. To solve this problem, we plan to continue basic research and clinical research on ovarian cancer treatment to improve the treatment results by developing intraperitoneal treatments such as HIPEC."