title: Cytoreduction surgery with hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer improves progression-free survival, especially in BRCA-positive patients- a case-control study.
abstract: BACKGROUND
  Approximately 70% of women diagnosed with advanced-stage ovarian cancer experience disease recurrence. Survival data were compared between a group of recurrent epithelial ovarian cancer (rEOC) patients treated by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) and a matched group of rEOC patients treated by systemic chemotherapy only (without surgery). Treatment outcome in relation to the patients' BRCA status was compared.
  
  
  METHODS
  Twenty-seven rEOC patients treated by cytoreduction and HIPEC were selected from our database and matched (1:3) with 84 rEOC patients treated with chemotherapy only. Progression-free survival (PFS) and overall survival (OS) in the two groups were analyzed and compared.
  
  
  RESULTS
  The estimated median PFS was 15 months in the HIPEC group and 6 months in the systemic chemotherapy group (P = 0.001). The median OS following HIPEC treatment has not been reached, since more than 70% of the women were alive at the time of analysis. The 5-year survival rate was significantly higher in the HIPEC treated patients compared to that of the controls (79% vs. 45%, P = 0.016). BRCA status did not affect PFS.
  
  
  CONCLUSIONS
  HIPEC after surgical cytoreduction in patients with rEOC appears beneficial compared to systemic chemotherapy treatment alone. The benefit is even greater in BRCA mutation carriers.
authors: Department of Oncology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: Tamar
authors: T
authors: Safra
authors: Dan
authors: D
authors: Grisaru
authors: Moshe
authors: M
authors: Inbar
authors: Subhi
authors: S
authors: Abu-Abeid
authors: Danit
authors: D
authors: Dayan
authors: Diana
authors: D
authors: Matceyevsky
authors: Anat
authors: A
authors: Weizman
authors: Joseph M
authors: JM
authors: Klausner
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000235:genetics / Q000401:mortality* / Q000628:therapy*; D016022:Case-Control Studies; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy / Q000379:methods; D065426:Cytoreduction Surgical Procedures; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D018095:Germ-Line Mutation; D006801:Humans; D006979:Hyperthermia, Induced; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000235:genetics / Q000401:mortality* / Q000628:therapy*
keywords: BRCA; hyperthermic intraperitoneal chemotherapy; recurrent ovarian cancer; surgical cytoreduction