Comparative analysis of open versus closed hyperthermic intraperitoneal chemotherapy techniques in the treatment of advanced ovarian cancer: A retrospective multicenter study (KGOG-3042 ancillary study)

초록

Objectives: Hyperthermic intraperitoneal chemotherapy (HIPEC) is a key treatment for ovarian cancer following neoadjuvant chemotherapy and interval cytoreductive surgery (NACT-ICS), with ongoing debates regarding the efficacy of open versus closed techniques. This study aimed to compare clinical outcomes and survival rates between open and closed HIPEC in advanced ovarian cancer patients treated with NACT-ICS. Methods: A retrospective analysis was conducted on 110 patients with advanced-stage ovarian cancer across multiple centers, with 63 patients undergoing open HIPEC and 47 patients undergoing closed HIPEC at the time of interval cytoreductive surgery. Patient demographics, surgical details, and postoperative outcomes were compared between the two groups. Survival outcomes were assessed using Kaplan-Meier survival curves and compared with the log-rank test. Results: The median age of the patients was 55 years (range: 36–77), and the majority of patients were in FIGO stage III (75%). There were no significant differences in baseline characteristics, such as age (P = 0.453), histology (P = 0.948), and FIGO stage (P = 0.125), between the open and closed HIPEC groups. The closed HIPEC group had a shorter median operative time than the open HIPEC group (425 vs 524 min, P = 0.0006). There was no significant difference in the incidence of grade 3/4 complications (P = 0.253) or in the time to adjuvant chemotherapy (25 vs 22 days, P = 0.06). Kaplan-Meier analysis showed no significant differences in progression-free survival (P = 0.308) or overall survival (P = 0.941) between the two techniques. Conclusions: In ovarian cancer patients, there were no significant differences in survival rates between open and closed HIPEC. This suggests that both techniques may be viable options depending on patient characteristics and clinical context.