2393122726ff15c7bed604f9b22607a9 pmc_10486645.pdf 2d52d6ab3abe1c5e9d3ea1669f99cd181ebd18fd pmc_10486645.pdf a3627ab2d72de35457e0bd52128ec97b7bb5bb347d0df3f68baeb9ed7d601d24 pmc_10486645.pdf Title: Neoadjuvant Chemotherapy plus Interval Cytoreductive Surgery with or without Hyperthermic Intraperitoneal Chemotherapy (NIHIPEC) in the Treatment of Advanced Ovarian Cancer: A Multicentric Propensity Score Study Subject: Introduction: Epithelial ovarian cancer (EOC) is primarily confined to the peritoneal cavity. When primary complete surgery is not possible, neoadjuvant chemotherapy (NACT) is provided; however, the peritoneum-plasma barrier hinders the drug effect. The intraperitoneal administration of chemotherapy could eliminate residual microscopic peritoneal tumor cells and increase this effect by hyperthermia. Intraperitoneal hyperthermic chemotherapy (HIPEC) after interval cytoreductive surgery could improve outcomes in terms of disease-free survival (DFS) and overall survival (OS). Materials and Methods: A multicenter, retrospective observational study of advanced EOC patients who underwent interval cytoreductive surgery alone (CRSnoH) or interval cytoreductive surgery plus HIPEC (CRSH) was carried out in Spain between 07/2012 and 12/2021. A total of 515 patients were selected. Progression-free survival (PFS) and OS analyses were performed. The series of patients who underwent CRSH or CRSnoH was balanced regarding the risk factors using a statistical analysis technique called propensity score matching. Results: A total of 170 patients were included in each subgroup. The complete surgery rate was similar in both groups (79.4% vs. 84.7%). The median PFS times were 16 and 13 months in the CRSH and CRSnoH groups, respectively (Hazard ratio (HR) 0.74; 95% CI, 0.58–0.94; p = 0.031). The median OS times were 56 and 50 months in the CRSH and CRSnoH groups, respectively (HR, 0.88; 95% CI, 0.64–1.20; p = 0.44). There was no increase in complications in the CRSH group. Conclusion: The addition of HIPEC after interval cytoreductive surgery is safe and increases DFS in advanced EOC patients. Keywords: hyperthermic intraperitoneal chemotherapy; advanced ovarian cancer; neoadjuvant chemotherapy; complete surgery; prgresion free survival; overall survival Author: Antoni Llueca, Maria Victoria Ibañez, Pedro Cascales, Antonio Gil-Moreno, Vicente Bebia, Jordi Ponce, Sergi Fernandez, Alvaro Arjona-Sanchez, Juan Carlos Muruzabal, Nadia Veiga, Berta Diaz-Feijoo, Cristina Celada, Juan Gilabert-Estelles, Cristina Aghababyan, Javier Lacueva, Alicia Calero, Juan Jose Segura, Karina Maiocchi, Sara Llorca, Alvaro Villarin, Maria Teresa Climent, Katty Delgado, Anna Serra, Luis Gomez-Quiles, Maria Llueca and on behalf of Spain GOG and GECOP Working Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Sat Aug 26 10:15:14 2023 CEST ModDate: Sat Aug 26 10:31:43 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3873726 bytes Optimized: no PDF version: 1.7 name 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yes yes no 202 0 CDFODG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 213 0 CDFODI+PalatinoLinotype TrueType WinAnsi yes yes no 216 0 CDFODK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 219 0 CDFPAG+PalatinoLinotype TrueType MacRoman yes yes no 222 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-02-02 02:33:06 CET RepresentationInformation: pmc_10486645.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-10-07 02:18:03 CEST Size: 3873726 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 404 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Patient Inclusion and Exclusion Criteria Destination: subsection.2.2 Item: Title: Disease-Free Survival and Overall Survival Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Results Destination: section.3 Children: Item: Title: Unmatched Series Destination: subsection.3.1 Item: Title: Matched Series Destination: subsection.3.2 Item: Title: Survival Analysis Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Strengths and Weakness Destination: subsection.4.1 Item: Title: Future Perspectives Destination: subsection.4.2 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Neoadjuvant Chemotherapy plus Interval Cytoreductive Surgery with or without Hyperthermic Intraperitoneal Chemotherapy (NIHIPEC) in the Treatment of Advanced Ovarian Cancer: A Multicentric Propensity Score Study Author: Antoni Llueca, Maria Victoria Ibañez, Pedro Cascales, Antonio Gil-Moreno, Vicente Bebia, Jordi Ponce, Sergi Fernandez, Alvaro Arjona-Sanchez, Juan Carlos Muruzabal, Nadia Veiga, Berta Diaz-Feijoo, Cristina Celada, Juan Gilabert-Estelles, Cristina Aghababyan, Javier Lacueva, Alicia Calero, Juan Jose Segura, Karina Maiocchi, Sara Llorca, Alvaro Villarin, Maria Teresa Climent, Katty Delgado, Anna Serra, Luis Gomez-Quiles, Maria Llueca and on behalf of Spain GOG and GECOP Working Group Subject: Introduction: Epithelial ovarian cancer (EOC) is primarily confined to the peritoneal cavity. When primary complete surgery is not possible, neoadjuvant chemotherapy (NACT) is provided; however, the peritoneum-plasma barrier hinders the drug effect. The intraperitoneal administration of chemotherapy could eliminate residual microscopic peritoneal tumor cells and increase this effect by hyperthermia. Intraperitoneal hyperthermic chemotherapy (HIPEC) after interval cytoreductive surgery could improve outcomes in terms of disease-free survival (DFS) and overall survival (OS). Materials and Methods: A multicenter, retrospective observational study of advanced EOC patients who underwent interval cytoreductive surgery alone (CRSnoH) or interval cytoreductive surgery plus HIPEC (CRSH) was carried out in Spain between 07/2012 and 12/2021. A total of 515 patients were selected. Progression-free survival (PFS) and OS analyses were performed. The series of patients who underwent CRSH or CRSnoH was balanced regarding the risk factors using a statistical analysis technique called propensity score matching. Results: A total of 170 patients were included in each subgroup. The complete surgery rate was similar in both groups (79.4% vs. 84.7%). The median PFS times were 16 and 13 months in the CRSH and CRSnoH groups, respectively (Hazard ratio (HR) 0.74; 95% CI, 0.58 0.94; p = 0.031). The median OS times were 56 and 50 months in the CRSH and CRSnoH groups, respectively (HR, 0.88; 95% CI, 0.64 1.20; p = 0.44). There was no increase in complications in the CRSH group. Conclusion: The addition of HIPEC after interval cytoreductive surgery is safe and increases DFS in advanced EOC patients. 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