• Y R Huo, A Richards, W Liauw, and D L Morris.
• Department of Surgery, St George Hospital, University of New South Wales, Kogarah, Sydney, NSW 2217, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia.
• Eur J Surg Oncol. 2015 Dec 1; 41 (12): 1578-89.

PurposeEmerging evidence suggests that hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) shows a survival benefit over CRS alone for patients with epithelial ovarian carcinoma (EOC). This systematic review and meta-analysis will assess the safety and efficacy of HIPEC with CRS for EOC.DesignSearches of five databases from inception to 17/02/15 was performed. Clinical outcomes were synthesised, with full tabulation of results.ResultsA total of 9 comparative studies and 28 studies examining HIPEC + CRS for primary and/or recurrent EOC were included. Meta-analysis of the comparative studies showed HIPEC + CRS + chemotherapy had significantly better 1-year survival compared with CRS + chemotherapy alone (OR: 3.76, 95% CI 1.81-7.82). The benefit of HIPEC + CRS continued for 2-, 3-, 4-, 5- and 8-year survival compared to CRS alone (OR: 2.76, 95% CI 1.71-4.26; OR: 5.04, 95% CI 3.24-7.85; OR: 3.51, 95% CI 2.00-6.17; OR: 3.46 95% CI 2.19-5.48; OR: 2.42, 95% 1.38-4.24, respectively). Morbidity and mortality rates were similar. Pooled analysis of all studies showed that among patients with primary EOC, the median, 1-, 3-, and 5-year overall survival rates are 46.1 months, 88.2%, 62.7% and 51%. For recurrent EOC, the median, 1-, 3-, and 5-year overall survival rates are 34.9 months, 88.6%, 64.8% and 46.3%. A step-wise positive correlation between completeness of cytoreduction and survival was found.ConclusionThe addition of HIPEC to CRS and chemotherapy improves overall survival rates for both primary and recurrent EOC.Copyright © 2015 Elsevier Ltd. All rights reserved.

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