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We assessed the perioperative outcomes and PFS of FIGO stage IV and\/or patients receiving up to 6 cycles of NACT undergoing IDS+HIPEC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Prospectively collected cases from January 1, 2019 to July 31, 2022 were included. Patients underwent HIPEC if: age \u2265\u200918 years but &lt;\u200975 years, body mass index \u2264\u200935 kg\/m<jats:sup>2<\/jats:sup>, ASA score \u2264\u20092, FIGO stage III\/IV epithelial disease treated with up to 6 cycles of NACT, and residual disease &lt;\u20092.5 mm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 205 patients were included. No difference was found in baseline characteristics between FIGO Stage III and IV patients, whereas rate of stable disease after NACT (<jats:italic>p<\/jats:italic> = 0.004), mean surgical complexity score at IDS (<jats:italic>p<\/jats:italic> = 0.001), and bowel resection rate (<jats:italic>p<\/jats:italic> = 0.046) were higher in patients undergoing delayed IDS. A lower rate of patients with at least one G3\u2013G5 postoperative complications was observed in FIGO stage IV versus FIGO stage III disease (5.3% vs. 14.0%; <jats:italic>p<\/jats:italic> = 0.052). This difference was confirmed at multivariable analysis (odds ratio [OR] 0.24; 95% confidence interval [CI] 0.07\u20130.80; <jats:italic>p<\/jats:italic> = 0.02), whereas age, SCS, bowel resection, and number of cycles did not affect postoperative complications. No difference in PFS was identified neither between FIGO stage III and IV patients (<jats:italic>p<\/jats:italic> = 0.44), nor between 3 and 4 versus &gt; 4 cycles of NACT (<jats:italic>p<\/jats:italic> = 0.85).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Because of the absence of additional complications and positive survival outcomes, HIPEC administration can be considered in selected FIGO stage IV and patients receiving &gt; 4 cycles of NACT.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1245\/s10434-024-15042-0","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T15:02:14Z","timestamp":1709046134000},"page":"3350-3360","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Expanding the Use of HIPEC in Ovarian Cancer at Time of Interval Debulking Surgery to FIGO Stage IV and After 6 Cycles of Neoadjuvant Chemotherapy: A Prospective Analysis on Perioperative and Oncologic Outcomes"],"prefix":"10.1245","volume":"31","author":[{"given":"Valentina","family":"Ghirardi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Trozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Romana","family":"Scanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Giannarelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Santullo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Costantini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Naldini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Panico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Frassanito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Scambia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fagotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,27]]},"reference":[{"issue":"6","key":"15042_CR1","doi-asserted-by":"publisher","first-page":"394","DOI":"10.3322\/caac.21492","volume":"68","author":"F Bray","year":"2018","unstructured":"Bray F, Ferlay J, Soerjomataram I, et al. 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All other authors declare no conflict of interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}