ArticleJournal of gynecologic oncology2026
Pattern of first recurrence in advanced epithelial ovarian, fallopian tube and peritoneal cancers treated with cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy.
Article in Journal of gynecologic oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveRecurrence patterns and survival outcomes in advanced epithelial ovarian cancer (EOC) treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) remain poorly understood. This post hoc analysis aimed to evaluate patterns of initial recurrence in patients with advanced EOC.
methodsThis analysis of the KOV-HIPEC1 trial included 142 patients with recurrent EOC divided into HIPEC and non-HIPEC groups. Baseline characteristics, recurrence patterns, and post-recurrence survival (PRS) were analyzed.
resultsAmong 142 patients with recurrent disease, recurrence patterns were comparable between the HIPEC and non-HIPEC groups, including rates of peritoneal seeding (80.0% vs. 70.1%, p=0.178), lymphatic involvement (47.7% vs. 49.4%, p=0.844), and parenchymal metastases (10.8% vs. 15.6%). In the BRCA-mutated subgroup, peritoneal seeding was significantly more common in the HIPEC group than in the non-HIPEC group (81.8% vs. 33.3%, p=0.036). PRS did not differ significantly between the HIPEC and control groups (p=0.571). Gastrointestinal events at recurrence were less frequent in the HIPEC group, including intestinal obstruction (1.9% vs. 9.3%), ostomy formation (0% vs. 3.1%), intestinal surgery (0% vs. 5.6%) and nasogastric tube placement (1.9% vs. 7.4%).
conclusionNo significant differences in recurrence pattern or survival outcome were observed between CRS with HIPEC and CRS alone. However, distinct recurrence patterns observed in BRCA-mutated patients suggest potential biological differences that may influence treatment outcomes. A trend toward reduced gastrointestinal morbidity in the HIPEC group, potentially reflecting a more subtle, less invasive recurrence pattern. Further research is warranted to elucidate these observations.
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