Hyperthermic intraperitoneal chemotherapy (HIPEC) for primary advanced-stage or recurrent ovarian cancer: A systematic review and meta-analysis of randomized control trials
Ovarian cancer has the highest mortality among gynecologic malignancies. Despite cytoreductive surgery (CRS) and systemic therapy, peritoneal recurrence remains common. Hyperthermic intraperitoneal chemotherapy (HIPEC) delivers heated chemotherapy directly to the peritoneal cavity, enhancing local cytotoxicity and offering a potential therapeutic strategy. We searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs) comparing CRS plus HIPEC versus CRS alone. Hazard ratios (HR), odds ratios (OR), and mean differences (MD) were pooled using Review Manager 5.4. Heterogeneity was assessed using I Eight RCTs (1259 patients) were included; 636 (50.52%) received CRS with HIPEC. HIPEC significantly improved OS (HR 0.79; 95% CI 0.67-0.94; p = 0.006; I In ovarian cancer, HIPEC significantly improved OS, especially in primary disease and following NACT. However, increased morbidity was observed. Further studies should refine patient selection and optimize protocols.