Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses
BackgroundThe utility of heated intraperitoneal chemotherapy (HIPEC) in the management of epithelial ovarian cancer (EOC) has been assessed in several randomised clinical trials and meta-analyses, and it is still a subject of controversy. Therefore, we performed an umbrella review of existing meta-a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.809773/full |
| _version_ | 1811306227693518848 |
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| author | Amine Souadka Hajar Essangri Mohammed Anass Majbar Amine Benkabbou Saber Boutayeb Benoit You Olivier Glehen Raouf Mohsine Naoual Bakrin |
| author_facet | Amine Souadka Hajar Essangri Mohammed Anass Majbar Amine Benkabbou Saber Boutayeb Benoit You Olivier Glehen Raouf Mohsine Naoual Bakrin |
| author_sort | Amine Souadka |
| collection | DOAJ |
| description | BackgroundThe utility of heated intraperitoneal chemotherapy (HIPEC) in the management of epithelial ovarian cancer (EOC) has been assessed in several randomised clinical trials and meta-analyses, and it is still a subject of controversy. Therefore, we performed an umbrella review of existing meta-analyses to summarise the outcomes of HIPEC and cytoreductive surgery (CRS) association in ovarian cancer.MethodsWe examined the MEDLINE, Cochrane Library, Scopus, Prospero, Web of Science and Science Direct from inception to May 30, 2020, for meta-analyses of randomised controlled trials and observational studies. Analyses of overall survival, disease free survival and progression survival were performed separately for primary and recurrent ovarian cancers.ResultsWe identified 6 meta-analyses investigating the association of HIPEC with CRS in the management of ovarian cancer. Three year overall survival was significantly improved by the association of CRS and HIPEC for primary (HR: 0.66, 95%CI:0.56-0.78) and recurrent ovarian cancers (HR:0.50, 95%CI:0.38-0.64). This benefit was also demonstrated on disease-free survival for primary (HR: 0.54, 95%CI:0.48-0.61) and recurrent ovarian cancer (HR: 0.60, 95%CI:0.46-0.78). The pooled hazard ratios confirmed the advantage of HIPEC and CRS association with respect to CRS alone on progression free survival for primary and recurrent ovarian cancer respectively with HR: 0.50, 95%CI: 0.43-0.58 and HR: 0.59, 95%CI: 0.41-0.85.ConclusionWhile waiting for the results of the current prospective studies, the present umbrella study suggests that HIPEC performed at the end of CRS may be a complementary effective asset for ovarian cancer patient management. |
| first_indexed | 2024-04-13T08:41:43Z |
| format | Article |
| id | doaj.art-fd906d5f79c945838c707dd39f7422d8 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-13T08:41:43Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-fd906d5f79c945838c707dd39f7422d82022-12-22T02:53:54ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-05-011210.3389/fonc.2022.809773809773Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-AnalysesAmine Souadka0Hajar Essangri1Mohammed Anass Majbar2Amine Benkabbou3Saber Boutayeb4Benoit You5Olivier Glehen6Raouf Mohsine7Naoual Bakrin8Surgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoSurgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoSurgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoSurgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoMedical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoDépartement d’oncologie médicale Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, FranceDépartement de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, FranceSurgical Oncology Department, National Institute of Oncology, University Mohammed V in Rabat, Rabat, MoroccoDépartement de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Lyon, FranceBackgroundThe utility of heated intraperitoneal chemotherapy (HIPEC) in the management of epithelial ovarian cancer (EOC) has been assessed in several randomised clinical trials and meta-analyses, and it is still a subject of controversy. Therefore, we performed an umbrella review of existing meta-analyses to summarise the outcomes of HIPEC and cytoreductive surgery (CRS) association in ovarian cancer.MethodsWe examined the MEDLINE, Cochrane Library, Scopus, Prospero, Web of Science and Science Direct from inception to May 30, 2020, for meta-analyses of randomised controlled trials and observational studies. Analyses of overall survival, disease free survival and progression survival were performed separately for primary and recurrent ovarian cancers.ResultsWe identified 6 meta-analyses investigating the association of HIPEC with CRS in the management of ovarian cancer. Three year overall survival was significantly improved by the association of CRS and HIPEC for primary (HR: 0.66, 95%CI:0.56-0.78) and recurrent ovarian cancers (HR:0.50, 95%CI:0.38-0.64). This benefit was also demonstrated on disease-free survival for primary (HR: 0.54, 95%CI:0.48-0.61) and recurrent ovarian cancer (HR: 0.60, 95%CI:0.46-0.78). The pooled hazard ratios confirmed the advantage of HIPEC and CRS association with respect to CRS alone on progression free survival for primary and recurrent ovarian cancer respectively with HR: 0.50, 95%CI: 0.43-0.58 and HR: 0.59, 95%CI: 0.41-0.85.ConclusionWhile waiting for the results of the current prospective studies, the present umbrella study suggests that HIPEC performed at the end of CRS may be a complementary effective asset for ovarian cancer patient management.https://www.frontiersin.org/articles/10.3389/fonc.2022.809773/fullumbrella reviewepithelial ovarian cancerHIPECmeta-analysisperitoneal carcinomatosis (PC)cytoreductive surgery and HIPEC |
| spellingShingle | Amine Souadka Hajar Essangri Mohammed Anass Majbar Amine Benkabbou Saber Boutayeb Benoit You Olivier Glehen Raouf Mohsine Naoual Bakrin Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses Frontiers in Oncology umbrella review epithelial ovarian cancer HIPEC meta-analysis peritoneal carcinomatosis (PC) cytoreductive surgery and HIPEC |
| title | Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses |
| title_full | Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses |
| title_fullStr | Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses |
| title_full_unstemmed | Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses |
| title_short | Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in Ovarian Cancer: An Umbrella Review of Meta-Analyses |
| title_sort | hyperthermic intraperitoneal chemotherapy and cytoreductive surgery in ovarian cancer an umbrella review of meta analyses |
| topic | umbrella review epithelial ovarian cancer HIPEC meta-analysis peritoneal carcinomatosis (PC) cytoreductive surgery and HIPEC |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.809773/full |
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