Revisiting intraperitoneal chemotherapy for advanced high-grade serous ovarian cancer

Abstract

Objective: To compare overall survival (OS) in patients with high-grade serous ovarian cancer (HGSOC) treated with intraperitoneal (IP) chemotherapy versus intravenous (IV) chemotherapy. Methods: A retrospective study of Stage III HGSOC with optimal primary cytoreduction during 2007–2019, followed by adjuvant IP or IV chemotherapy. Results: Overall, 54 patients were included, 23 (43%) treated by IP and 31 (57%) by IV chemotherapy. Median progression-free survival (PFS) in the IP group was 39 months (95% confidence interval [CI] 34–44 months) versus 23 months (95% CI 18–28 months) in the IV group (P = 0.294). The IP chemotherapy had superior OS compared with IV chemotherapy, with median OS not reached, versus 76 months (95% CI 37–115 months) for the IV group (P = 0.075, hazard ratio 0.45, 95% CI 0.18–1.10). At 72 months, OS was 82% for the IP group versus 53% in the IV group. In a sensitivity analysis for Stage IIIc patients only (n = 39), the median OS was 130 months (95% CI 86–174 months) in the IP group, compared with 56 months (95% CI 35–76 months) for the IV group (P = 0.152). Toxicity profiles were similar in both groups, with no Grade ≥3 toxicity. Conclusion: Stage III HGSOC patients treated with IP chemotherapy had significantly longer OS.