TY - JOUR
T1 - Real-world use and outcomes of hyperthermic intra-peritoneal chemotherapy for stage III ovarian cancer
AU - Lot Aronson, S.
AU - van Stein, Ruby M.
AU - Algera, Marc D.
AU - Lopez-Yurda, M.
AU - van der Aa, Maaike A.
AU - Lok, Christianne A.R.
AU - de Hingh, Ignace H.J.T.
AU - Sonke, Gabe S.
AU - van Driel, Willemien J.
AU - van Driel, Willemien J.
AU - Schreuder, Hendrik W.R.
AU - Hermans, Ralph H.M.
AU - van Gent, Mignon D.J.M.
AU - Roelofsen, Thijs
AU - van Ham, Maaike A.P.C.
AU - Reesink, Nathalie
AU - de Kroon, Cor D.
AU - Lambrechts, Sandrijne
AU - Roes, Eva Maria
AU - Dutch OVHIPEC study group
N1 - Publisher Copyright:
© 2026 European Society of Gynaecological Oncology and the International Gynecologic Cancer Society. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
PY - 2026/7
Y1 - 2026/7
N2 - Objective: OVHIPEC-1 demonstrated improved survival with adding hyperthermic intra-peritoneal chemotherapy (HIPEC) to interval cytoreductive surgery in patients with stage III epithelial ovarian cancer. Following these findings, HIPEC was incorporated into Dutch national guidelines in 2019. This study evaluated HIPEC use and its impact on outcomes in routine clinical practice in The Netherlands. Methods: This nationwide, population-based study included all Dutch patients with stage III ovarian cancer who underwent complete or optimal interval cytoreductive surgery between 2020 and 2021. We evaluated HIPEC use and analyzed associations with patient characteristics, early post-operative outcomes, and overall survival. Multi-variable logistic, linear, and Cox regression models were used with multiple imputation and adjustment for key prognostic factors, including cytoreduction outcome and histological subtype. Adjusted overall survival was estimated using inverse probability of treatment weighting. Results: The study included 473 patients. HIPEC use increased from 56% in 2020 to 63% in 2021. Patients receiving HIPEC were generally younger, had better performance status, stage IIIC disease, and more often achieved complete cytoreduction. Bowel surgery with stoma creation was more common among HIPEC patients. After adjusting for important prognostic factors, median hospital stay was longer for the HIPEC group than the cytoreductive surgery-only (7 [interquartile range {IQR} 6-9] vs 6 days [IQR 5-8], p < .0001), with no significant difference in post-operative complications or start of adjuvant chemotherapy. HIPEC was associated with significantly improved overall survival compared to surgery-only (adjusted 3-year overall survival; 62% (95% confidence interval [CI] 53 to 72) vs 51% (95% CI 42 to 61), adjusted hazard ratio 0.69, 95% CI 0.48 to 0.99, p=.044). Conclusions: Following its inclusion in Dutch national guidelines, HIPEC was administered to 63% of eligible patients by 2021. The effects of HIPEC on early post-operative outcomes and overall survival align with those reported in randomized trials. These findings support the effectiveness and safety of HIPEC in clinical practice and its integration into in stage III ovarian cancer treatment protocols.
AB - Objective: OVHIPEC-1 demonstrated improved survival with adding hyperthermic intra-peritoneal chemotherapy (HIPEC) to interval cytoreductive surgery in patients with stage III epithelial ovarian cancer. Following these findings, HIPEC was incorporated into Dutch national guidelines in 2019. This study evaluated HIPEC use and its impact on outcomes in routine clinical practice in The Netherlands. Methods: This nationwide, population-based study included all Dutch patients with stage III ovarian cancer who underwent complete or optimal interval cytoreductive surgery between 2020 and 2021. We evaluated HIPEC use and analyzed associations with patient characteristics, early post-operative outcomes, and overall survival. Multi-variable logistic, linear, and Cox regression models were used with multiple imputation and adjustment for key prognostic factors, including cytoreduction outcome and histological subtype. Adjusted overall survival was estimated using inverse probability of treatment weighting. Results: The study included 473 patients. HIPEC use increased from 56% in 2020 to 63% in 2021. Patients receiving HIPEC were generally younger, had better performance status, stage IIIC disease, and more often achieved complete cytoreduction. Bowel surgery with stoma creation was more common among HIPEC patients. After adjusting for important prognostic factors, median hospital stay was longer for the HIPEC group than the cytoreductive surgery-only (7 [interquartile range {IQR} 6-9] vs 6 days [IQR 5-8], p < .0001), with no significant difference in post-operative complications or start of adjuvant chemotherapy. HIPEC was associated with significantly improved overall survival compared to surgery-only (adjusted 3-year overall survival; 62% (95% confidence interval [CI] 53 to 72) vs 51% (95% CI 42 to 61), adjusted hazard ratio 0.69, 95% CI 0.48 to 0.99, p=.044). Conclusions: Following its inclusion in Dutch national guidelines, HIPEC was administered to 63% of eligible patients by 2021. The effects of HIPEC on early post-operative outcomes and overall survival align with those reported in randomized trials. These findings support the effectiveness and safety of HIPEC in clinical practice and its integration into in stage III ovarian cancer treatment protocols.
KW - Cytoreductive Surgery
KW - HIPEC
KW - Ovarian Cancer
U2 - 10.1016/j.ijgc.2026.104500
DO - 10.1016/j.ijgc.2026.104500
M3 - Article
SN - 1048-891X
VL - 36
JO - International Journal of Gynecological Cancer
JF - International Journal of Gynecological Cancer
IS - 7
M1 - 104500
ER -