{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T17:57:42Z","timestamp":1773338262796,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373450"],"award-info":[{"award-number":["82373450"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172885"],"award-info":[{"award-number":["82172885"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>The survival benefit of hyperthermic intraperitoneal chemotherapy (HIPEC) has been well defined at the time of interval cytoreductive surgery, but the role of HIPEC remains uncertain for patients with newly diagnosed advanced ovarian cancer in the upfront setting. The present study aimed to report the updated long\u2010term survival outcomes after 5\u2009years of follow\u2010up from our previous multicenter retrospective cohort study to compare primary cytoreductive surgery (PCS) plus HIPEC with PCS alone among women with stage III epithelial ovarian cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This study was conducted at five high\u2010volume gynecological medical centers in China from January 2010 to May 2017. Eligible patients with complete data were treated with either PCS combined with HIPEC or PCS alone. The 5\u2010year overall survival (OS) rate was updated to compare PCS plus HIPEC with PCS alone. The inverse probability of treatment weighting (IPTW) method based on a propensity score model for each patient was used to control the confounding factors and evaluate the effect of HIPEC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data from 789 patients, a total of 584 eligible stage III epithelial ovarian cancer patients were ultimately included in the analysis (PCS\u2010plus\u2010HIPEC group, <jats:italic>n<\/jats:italic>\u2009=\u2009425; PCS\u2010alone group, <jats:italic>n<\/jats:italic>\u2009=\u2009159). After IPTW adjustment, the median OS was 44.5 (95% CI, 40.1\u201349.1) months in the PCS\u2010plus\u2010HIPEC group and 32.4 (95% CI, 28.8\u201340.3) months in the PCS\u2010alone group (weighted hazard ratio, 0.74; 95% CI, 0.59\u20130.93; <jats:italic>p<\/jats:italic>\u2009=\u20090.006). At 5\u2009years, the OS rates were 37.9% (95% CI, 33.0%\u201342.8%) in the PCS\u2010plus\u2010HIPEC group and 26.4% (95% CI, 18.9%\u201334.6%) in the PCS\u2010alone group (<jats:italic>p<\/jats:italic>\u2009=\u20090.007). After stratification into optimal and suboptimal cytoreduction subgroups, patients in the PCS\u2010plus\u2010HIPEC group maintained a greater association with improved OS than those in the PCS\u2010alone group. Among the women who underwent optimal cytoreduction in the PCS\u2010plus\u2010HIPEC group and PCS\u2010alone group, the median OS was 49.9 (95% CI, 45.2\u201358.4) months and 37.8 (95% CI, 30.5\u201353.0) months (<jats:italic>p<\/jats:italic>\u2009=\u20090.042) while the 5\u2010year OS rate was 43.7% (95% CI, 37.7%\u201349.6%) and 33.2% (95% CI, 23.3%\u201343.5%), respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.040). Meanwhile, for those treated with suboptimal cytoreduction subgroup in the PCS\u2010plus\u2010HIPEC and PCS\u2010alone groups, the median OS was 28.4 (95% CI, 22.2\u201339.9) months and 20.6 (95% CI, 10.6\u201332.4) months (<jats:italic>p<\/jats:italic>\u2009=\u20090.099) while the 5\u2010year OS rate was 22.4% (95% CI, 15.1%\u201330.5%) and 12.2% (95% CI, 4.4%\u201324.2%), respectively (<jats:italic>p<\/jats:italic>\u2009=\u20090.060). The median follow\u2010up period was 87.2 (95% CI, 85.1\u201392.7) months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The updated results indicate that the addition of HIPEC is associated with improved long\u2010term survival outcomes beyond 5\u2009years for patients with stage III epithelial ovarian cancer in the upfront setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15094","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T12:05:14Z","timestamp":1741089914000},"page":"988-997","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Hyperthermic intraperitoneal chemotherapy after upfront cytoreductive surgery for stage <scp>III<\/scp> epithelial ovarian cancer: Follow\u2010up of long\u2010term survival"],"prefix":"10.1111","volume":"104","author":[{"given":"Ziying","family":"Lei","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Henan Provincial People's Hospital  Zhengzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Runya","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Gynaecological Oncology, Tianjin Medical University Cancer Institute &amp; Hospital National Clinical Research Center of Cancer  Tianjin China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Gynaecology and Obstetrics Huaihe Hospital of Henan University  Kaifeng China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangxiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingsi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery Guangzhou Institute of Cancer Research, The Affiliated Cancer Hospital, Guangzhou Medical University  Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiali","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery Guangzhou Institute of 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