Statement of the AGO Kommission Ovar, AGO Study Group, NOGGO, AGO Austria, Swiss AGO, BGOG, CEEGOG, GEICO, and SFOG regarding the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in epithelial ovarian cancer.

Mar 27, 2023

Experts: Philipp Harter,Gerhard Bogner,Luis Chiva,David Cibula,Nicole Concin,Christina Fotopoulou,Antonio Gonzalez-Martin,Frederic Guyon,Viola Heinzelmann-Schwarz,Frederic Kridelka,Sven Mahner,Frederik Marmé,Christian Marth,Philippe Morice,Zoltán Novák,Andrea Papadia,Isabelle Ray-Coquard,Mikuláš Redecha,Andres Redondo,Richard Schwameis,Jalid Sehouli,Manuela Undurraga,Toon Van Gorp,Ignace Vergote

An international joint statement about the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in ovarian cancer was published in 2016, warning about the uncritical use of HIPEC outside controlled studies. This statement has now been updated after the most recent literature was reviewed by the participating study groups and societies. HIPEC became a treatment option in patients with advanced colon cancer after positive results of a randomized trial comparing surgery and HIPEC versus palliative treatment alone. Although this trial did not compare the added value of HIPEC to surgery alone, HIPEC for the treatment of peritoneal metastases was in the subsequent years generalized to many other cancer types associated with peritoneal carcinomatosis including epithelial ovarian cancer (EOC). In the meantime, new evidence from prospective randomized trials specifically for EOC-patients emerged, with however contradicting results and several quality aspects that made the interpretation of their findings critical. Moreover, three additional trials in colorectal cancer failed to confirm the previously presumed survival benefit through the implementation of HIPEC in peritoneally disseminated colorectal cancers. Based on a still unclear and inconsistent landscape, the authors conclude that HIPEC should remain within the remit of clinical trials for EOC-patients. Available evidence is not yet sufficient to justify its broad endorsement into the routine clinical practice.
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ABOUT THE EXPERTS

Philipp Harter,Gerhard Bogner,Luis Chiva,David Cibula,Nicole Concin,Christina Fotopoulou,Antonio Gonzalez-Martin,Frederic Guyon,Viola Heinzelmann-Schwarz,Frederic Kridelka,Sven Mahner,Frederik Marmé,Christian Marth,Philippe Morice,Zoltán Novák,Andrea Papadia,Isabelle Ray-Coquard,Mikuláš Redecha,Andres Redondo,Richard Schwameis,Jalid Sehouli,Manuela Undurraga,Toon Van Gorp,Ignace Vergote

Philipp Harter

Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Henricistrasse 92, 45136 Essen, Germany. Electronic address: p.harter@kem-med.com.

Gerhard Bogner

Department of Obstetrics and Gynecology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Luis Chiva

Department of Obstetrics and Gynecology, Clinica Universidad de Navarra, Madrid, Spain.

David Cibula

Department of Obstetrics and Gynecology, General University Hospital in Prague, First Faculty of Medicine, Charles University, Prague, Czech Republic.

Nicole Concin

Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte, Henricistrasse 92, 45136 Essen, Germany; Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria.

Christina Fotopoulou

Departments of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.

Antonio Gonzalez-Martin

Medical Oncology Department Clínica Univerdad de Navarra, Madrid, and Program in Solid Tumours CIMA, Pamplona, Spain.

Frederic Guyon

Institut Bergonié, Bordeaux, France.

Viola Heinzelmann-Schwarz

University Hospital Basel, Basel, Switzerland.

Frederic Kridelka

Department of Obstetrics and Gynaecology, CHU de Liège, Liège, Belgium.

Sven Mahner

Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Munich, Germany.

Frederik Marmé

Department of Gynecologic Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Christian Marth

Department of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria.

Philippe Morice

Institut Gustave-Roussy, Villejuif, France.

Zoltán Novák

Department of Gynaecology, National Insitute of Oncology, Budapest, Hungary.

Andrea Papadia

Department of Gynecology and Obstetrics, Ospedale Regionale di Lugano EOC, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.

Isabelle Ray-Coquard

Centre Léon Bérard, Lyon, France.

Mikuláš Redecha

II. department of gynaecology and obstetrics, University Hospital Bratislava, Comenius University, Bratislava, Slovakia.

Andres Redondo

Medical Oncology Department, Hospital Universitario La Paz-IdiPAZ, Madrid, Spain.

Richard Schwameis

Division of General Gynecology and Gynecologic Oncology, Department of Obstetrics and Gynecology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.

Jalid Sehouli

Department of Gynecology with Center of Gynecological Oncology,Charité, University Medicine of Berlin, Berlin, Germany.

Manuela Undurraga

University Hospital Geneva (HUG), Geneva, Switzerland.

Toon Van Gorp

Division of Gynaecological Oncology, University Hospitals Leuven, Leuven, Belgium.

Ignace Vergote

Division of Gynaecological Oncology, University Hospitals Leuven, Leuven, Belgium.