The HIPEC procedure is combined with debulking surgery, during which all visible parts of the tumor are removed. Toward the end of this procedure, the abdomen is flushed with heated chemotherapy to target the invisible tumor cells. This reduces the chance of recurrence. This treatment specifically targets metastases in the peritoneum, which is characteristic of stage 3 ovarian cancer. Surgery may not be feasible for patients with metastases, so they receive neoadjuvant chemotherapy first. This surgery is referred to as 'interval debulking.'
Approximately 1,300 women in the Netherlands are diagnosed with ovarian cancer each year. In about 75% of these women, the tumor has already spread to the peritoneum by the time they receive their diagnosis. Following the results of the OVHIPEC-1 study, HIPEC treatment has been covered by health insurance since 2019, and the treatment is available throughout the country as a standard treatment for patients with stage 3 ovarian cancer receiving debulking surgery. A follow-up of nearly 5 years already showed that HIPEC treatment improved time to recurrence. Additionally, the treatments also improved overall survival outcomes compared to interval debulking without HIPEC.
The follow-up study followed 245 patients who participated in the study between 2007 and 2016, divided into two groups: those who had interval debulking surgery with or without HIPEC. “It is important to study the long-term effects because tumor recurrence can occur even after 5 years,” said physician-researcher Lot Aronson. A longer 10-year follow-up and observation of similar treatments between both groups further confirms the benefit of HIPEC treatment. Physician-researcher Lot Aronson: “The efficacy of HIPEC has already convinced us in the Netherlands, and this therapy has been included in standard treatment for several years, but internationally it is not yet part of standard treatment. This research can help us convince the world that HIPEC truly provides an advantage for patients.”
After determining the benefits of HIPEC for patients undergoing interval debulking, OVHIPEC-2 now investigates whether these same benefits occur in patients who had surgery directly and were given chemotherapy after (primary debulking). This trial is currently open in 27 centers throughout 7 countries and the results are expected in 2026.
This study was financially supported by KWF Dutch Cancer Society.