2022-RA-919-ESGO A pilot study of interval cytoreductive surgery and HIPEC for advanced epithelial ovarian cancer in the UK

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Introduction/Background The Christie is one of the first cancer referral centres to offer hyperthermic intraperitoneal chemotherapy (HIPEC) to patients with advanced epithelial ovarian cancer (AEOC) in the UK.Despite the OVHIPEC1-trial showing longer recurrence free and overall survival for patients undergoing interval cisplatin cytoreductive surgery (CRS) with the addition of HIPEC compared to CRS alone, HIPEC is not yet offered as NHS-funded treatment for AEOC. We report early follow up data on safety and feasibility of CRS+HIPEC in ovarian cancer patient at the Christie, including costs, adding to the evidence that HIPEC is a cost-efficient addition to current treatment for patients with AEOC. Methodology Patients with high grade AEOC who achieved a partial response to 3 or 4 cycles of neoadjuvant carboplatin and paclitaxel chemotherapy were selected for interval CRS+HIPEC. The procedure was performed by Gynaecological Surgical Oncologists in collaboration with Peritoneal Surgeons with extensive experience in performing HIPEC procedures. Closed HIPEC delivery technique was used. Cisplatin was perfused at a dose of 100 mg/m2. Results 9 patients have undergone CRS+HIPEC for AEOC at The Christie since October 2021. By the LBA submission deadline, this will be 10. We will report on median time to surgery from chemotherapy, pre- and postsurgical PCI score, mean length of stay and CCU stay, intra- and postoperative complications and 30 and 90 day mortality.Overall costs of the postoperative care of CRS+HIPEC will be compared to CRS alone in our setting. Conclusion Interval CRS+HIPEC is feasible and safe for AEOC in a tertiary cancer centre setting. There does not seem to be a significant difference in postoperative complication rate and associated costs compared to the current standard treatment of interval CRS alone.

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