1085 Survival and adverse treatment effects of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced stage ovarian cancer

Introduction/Background In treating advanced ovarian cancer marked by extensive peritoneal carcinomatosis, the optimal approach often combines cytoreductive surgery (CRS) and systemic chemotherapy. Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is explored as a complement method to CRS, exhibiting direct tumor cell exposure to cytotoxic drugs and potentially enhanced chemotherapeutic efficacy with hyperthermia. However, significant adverse effects and a reported HIPEC-related mortality rate of up to 10% limits its widespread adoption in standard clinical practice. This study aimed to present both survival and adverse treatment results for advanced ovarian cancer patients undergoing HIPEC, considering patients differences, characteristics and localization of tumor and therapeutic protocols. Methodology Medical data from all patients with advance stage ovarian cancer undergoing HIPEC over five years were analyzed. A multidisciplinary team guided treatment decisions based on factors such as age, Karnofsky status, ascites analysis, Peritoneal Cancer Index (PCI), and risk for peritoneal dissemination. HIPEC, following Sugarbaker's PCI criteria in selected patients post-CRS, utilized a closed approach method and a 90-minute chemotherapeutic regimen of doxorubicin and cisplatin. Results As of 2021, 22 patients underwent CRS and HIPEC, predominantly due to the high-grade serous carcinoma (20 cases) and a low-grade mucinous and clear cell carcinoma cases in remaining cases. Seventeen patients had primary ovarian cancer, four experienced recurrences. Complications, including pulmonary embolism, superficial femoral vein thrombosis, and ileus, were observed in three cases. No HIPEC-related hematological complications or renal failure occurred. Disease recurrence was noted in one patient after two years, and two patients died post-primary treatment, at 7 months and 4 years, respectively, following CRS and HIPEC. Conclusion In the examined cohort, there is no distinct evidence supporting HIPEC and related mortality or adverse treatment outcomes. Disclosures The authors have no conflicts of interest to declare.