Long term survival of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in advanced epithelial ovarian cancer

Background: To compare the efficacy of conventional debulking surgery and cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with the peritoneal metastasis of epithelial ovarian cancer (EOCPC). Methods: In patients with ovarian cancer who underwent surgery-based multidisciplinary treatment at our center from May 2004 to November 2019, 186 EOCPC patients were divided into a control group (conventional debulking surgery, n=115) and a study group (CRS+HIPEC, n=71) and were matched for baseline characteristics by propensity score matching (PSM). The endpoints were median overall survival (mOS) and median progression-free survival (mPFS). Results: After matching, 133 patients met the selection criteria, including 80 patients in the control group and 53 patients in the study group. The mOS in the study group was significantly longer than that in the control group (87.3 vs. 25.2 months, respectively, P=0.002). For complete cytoreduction, the mPFS in the study group was significantly longer than that in the control group [(19.6 vs. 10.1 months, respectively, P=0.007)]. For complete CRS, the mOS in the study group was significantly longer than that in the control group [103.3 vs. 46.2 months, respectively, P=0.020]. For incomplete CRS, the mOS in the study group was not different between the two groups. Conclusions: Standardized CRS+HIPEC can contribute significant survival benefits to patients with EOCPC.