Secondary cytoreductive surgery with HIPEC: a promising therapeutic option for recurrent ovarian cancer

Mené sur 415 patientes atteintes d'un cancer de l'ovaire récidivant (durée médiane de suivi : 6,2 ans), cet essai randomisé international de phase III évalue l'efficacité, du point de vue de la survie globale, d'une chimiothérapie hyperthermique intrapéritonéale lors d'une chirurgie cytoréductive d'intervalle

Résumé en anglais

Despite comprehensive initial treatment, including radical surgery and systemic therapies, ovarian cancer is prone to recurrence.1 Patients with platinum-sensitive relapse might benefit from secondary cytoreductive surgery. Several sentinel clinical trials have investigated the impact of secondary cytoreductive surgery on survival with varying results. The DESKTOPIII trial demonstrated a clear survival benefit to secondary cytoreductive surgery, with a 7·8-month improvement in overall survival (53·7 months vs 46·0 months) and a 3·2-month improvement in progression free survival (18·4 months vs 14·0 months) compared with chemotherapy alone.2 Similarly, the SOC-1 trial showed improved progression-free survival and overall survival in patients who underwent complete secondary cytoreductive surgery.3 By contrast, the GOG213 trial did not show a significant difference in overall survival between patients undergoing secondary cytoreductive surgery followed by chemotherapy and those receiving chemotherapy alone.4 These discrepancies highlight the need for additional therapeutic strategies and emphasise the importance of careful patient selection.