Health-related quality of life after interval cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with stage III ovarian cancer

S.N. Koole, J.M. Kieffer, K. Sikorska, J.H. Schagen van Leeuwen, H.W.R. Schreuder, R.H. Hermans, I.H. de Hingh, J. van der Velden, H.J. Arts, M.A.P.C. van Ham, A.G. Aalbers, V.J. Verwaal, K.K. Van de Vijver, G.S. Sonke, W.J. van Driel, N.K. Aaronson

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Abstract

Introduction
The addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery (CRS) improves recurrence-free (RFS) and overall survival (OS) in patients with FIGO stage III ovarian cancer. We evaluated the effect of HIPEC on patient's health-related quality of life (HRQoL) in the OVHIPEC trial.

Materials and methods
OVHIPEC was a multicentre, open-label, randomized phase III trial for patients with stage III ovarian cancer. Patients were randomly assigned (1:1) to receive interval CRS with or without HIPEC with cisplatin. HRQoL was assessed using the EORTC QLQ-C30, and the ovarian (QLQ-OV28) and colorectal cancer (QLQ-CR38) modules. HRQoL questionnaires were administered at baseline, after surgery, after end of treatment, and every three months thereafter. HRQoL was a secondary endpoint, with the prespecified focus on the QLQ-C30 summary score and symptom scores on fatigue, neuropathy and gastro-intestinal symptoms. HRQoL was analysed using linear and non-linear mixed effect models.

Results
In total, 245 patients were randomized. One-hundred-ninety-seven patients (80%) completed at least one questionnaire. No significant difference over time in the QLQ-C30 summary scores was observed between the study arms (p-values for linear and non-linear growth: p > 0.133). The pattern over time for fatigue, neuropathy and gastro-intestinal symptoms did not significantly differ between treatment arms.

Conclusion
The addition of HIPEC to interval CRS does not negatively impact HRQoL in patients with stage III ovarian cancer who are treated with interval CRS due to the extent of disease. These HRQoL results, together with the improvement in RFS and OS, support the viability of HIPEC as an important treatment option in this patient population.
Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalEuropean Journal of Surgical Oncology
Volume47
Issue number1
Early online date13 May 2019
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Health-related quality of life (HRQoL)
  • Hyperthermic intraperitoneal chemotherapy (HIPEC)
  • Ovarian cancer

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