Dr. Leitao Discusses the Role of HIPEC in Advanced Ovarian Cancer

Mario M. Leitao Jr, MD, FACOG, FACS
Published: Monday, May 06, 2019



Mario M. Leitao Jr, MD, FACOG, FACS, fellowship director, gynecology service, director, Minimal Access and Robotic Surgery Program, Department of Surgery, Memorial Sloan Kettering Cancer Center, discusses the role of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced ovarian cancer.

HIPEC is one of the biggest topics in this space. Though many physicians offer HIPEC, there is little level 1 evidence to support its use, Leitao notes. Investigators in The Netherlands did a randomized trial in patients receiving neoadjuvant chemotherapy and interval debulking. Patients were randomized to receive HIPEC or not, followed by systemic therapy. Results showed a significant improvement in progression-free and overall survival, Leitao says.

That was the only randomized trial in this setting, so it’s something to take into consideration. However, if a surgeon has the proper training that would enable them to give HIPEC, they are justified in giving HIPEC to a patient undergoing interval debulking. The role of HIPEC in the setting of primary debulking and in the recurrent setting is still to be determined. A study at Memorial Sloan Kettering Cancer Center is nearing completion of accrual looking at HIPEC in patients with platinum-sensitive disease after first recurrence.
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Mario M. Leitao Jr, MD, FACOG, FACS, fellowship director, gynecology service, director, Minimal Access and Robotic Surgery Program, Department of Surgery, Memorial Sloan Kettering Cancer Center, discusses the role of hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with advanced ovarian cancer.

HIPEC is one of the biggest topics in this space. Though many physicians offer HIPEC, there is little level 1 evidence to support its use, Leitao notes. Investigators in The Netherlands did a randomized trial in patients receiving neoadjuvant chemotherapy and interval debulking. Patients were randomized to receive HIPEC or not, followed by systemic therapy. Results showed a significant improvement in progression-free and overall survival, Leitao says.

That was the only randomized trial in this setting, so it’s something to take into consideration. However, if a surgeon has the proper training that would enable them to give HIPEC, they are justified in giving HIPEC to a patient undergoing interval debulking. The role of HIPEC in the setting of primary debulking and in the recurrent setting is still to be determined. A study at Memorial Sloan Kettering Cancer Center is nearing completion of accrual looking at HIPEC in patients with platinum-sensitive disease after first recurrence.



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