{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:29:04Z","timestamp":1793730544422,"version":"4.6.1"},"reference-count":35,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Col. Bras. Cir."],"abstract":"<jats:p>ABSTRACT  Objective:  to report the final analysis of a phase 2 trial assessing the efficacy and safety of short-course hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with advanced epithelial ovarian cancer (EOC).  Methods:  this was an open-label, multicenter, single-arm trial of HIPEC in patients with advanced EOC who underwent interval cytoreductive surgery (iCRS) after neoadjuvant chemotherapy (NACT). HIPEC was performed as a concentration-based regimen of platinum-based chemotherapy for 30 minutes. Primary endpoint was the rate of disease progression occurring at nine months following iCRS plus HIPEC (PD9). Secondary endpoints were postoperative complications, time to start adjuvant chemotherapy, length of hospital and ICU stay, quality of life (QoL) over treatment, and ultimately 2-year progression-free survival (PFS) and overall survival (OS). Analysis was by intention-to-treat with final database lock for survival outcomes on February 23, 2021.  Results:  fifteen patients with stage III EOC were enrolled between February 2015 and July 2019, in four centers. The intention to treat PD9 was 6.7%. With a median follow-up of 33 months (IQR, 24.3-46.5), the median PFS was 18.1 months and corresponding 2-year rates of PFS and OS was 33.3% and 93.3%, respectively. Three patients (20%) experienced graded III complications. Median length of hospital and ICU stay was 5 (IQR, 4-6.5) and 1 (IQR, 1-1) days, respectively. Time to restart systemic chemotherapy was 39 (IQR, 35-49.3) days and no significant difference over time in QoL was observed.  Conclusions:  we demonstrate preliminary efficacy and safety of short-course HIPEC in patient with advanced EOC.<\/jats:p>","DOI":"10.1590\/0100-6991e-20223135","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T22:14:42Z","timestamp":1646172882000},"source":"Crossref","is-referenced-by-count":10,"title":["A phase 2 trial of short-course Hyperthermic IntraPeritoneal Chemotherapy (HIPEC) at interval cytoreductive surgery (iCRS) for advanced ovarian cancer"],"prefix":"10.1590","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-3205","authenticated-orcid":false,"given":"THALES PAULO","family":"BATISTA","sequence":"first","affiliation":[{"name":"Instituto de Medicina Integral Professor Fernando Figueira,  Brazil; Universidade Federal de Pernambuco,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8776-8837","authenticated-orcid":false,"given":"VANDR\u00c9 CABRAL GOMES","family":"CARNEIRO","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Professor Fernando Figueira,  Brazil; Hospital de C\u00e2ncer de Pernambuco,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RODRIGO","family":"TANCREDI","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Professor Fernando Figueira,  Brazil; Hospital de C\u00e2ncer de Pernambuco,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8741-166X","authenticated-orcid":false,"given":"LEVON","family":"BADIGLIAN FILHO","sequence":"additional","affiliation":[{"name":"AC Camargo Cancer Center,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4794-993X","authenticated-orcid":false,"given":"RONALDO L\u00daCIO COSTA","family":"RANGEL","sequence":"additional","affiliation":[{"name":"Instituto Brasileiro de Controle do C\u00e2ncer,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-8738","authenticated-orcid":false,"given":"ANDR\u00c9","family":"LOPES","sequence":"additional","affiliation":[{"name":"Instituto Brasileiro de Controle do C\u00e2ncer,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9023-8554","authenticated-orcid":false,"given":"BRUNO JOS\u00c9 QUEIROZ","family":"SARMENTO","sequence":"additional","affiliation":[{"name":"Instituto Hospital de Base do Distrito Federal,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-117X","authenticated-orcid":false,"given":"CRISTIANO SOUZA","family":"LE\u00c3O","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Integral Professor Fernando Figueira,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2022]]},"reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1056\/NEJMoa1708618","article-title":"Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer","volume":"378","author":"van Driel WJ","year":"2018","journal-title":"N Engl J Med"},{"issue":"5","key":"ref2","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1245\/s10434-014-4157-9","article-title":"Cytoreductive surgery and HIPEC in recurrent epithelial ovarian cancer a prospective randomized phase III study","volume":"22","author":"Spiliotis J","year":"2015","journal-title":"Ann Surg Oncol"},{"issue":"5","key":"ref3","doi-asserted-by":"crossref","first-page":"439","DOI":"10.3109\/02656739709023545","article-title":"Reduction of cellular cisplatin resistance by hyperthermia - a review","volume":"13","author":"Hettinga JV","year":"1997","journal-title":"Int J Hyperthermia"},{"issue":"12","key":"ref4","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1016\/j.ejso.2013.09.030","article-title":"Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma a French multicentre retrospective cohort study of 566 patients","volume":"39","author":"Bakrin N","year":"2013","journal-title":"Eur J Surg Oncol"},{"issue":"4","key":"ref5","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1245\/s10434-012-2784-6","article-title":"Hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis role of heat shock proteins and dissecting effects of hyperthermia","volume":"20","author":"Pelz JO","year":"2013","journal-title":"Ann Surg Oncol"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/onc.2015.82","article-title":"Hyperthermic intraperitoneal chemotherapy leads to an anticancer immune response via exposure of cell surface heat shock protein 90","volume":"35","author":"Zunino B","year":"2016","journal-title":"Oncogene"},{"issue":"26","key":"ref7","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1200\/JCO.2015.61.4776","article-title":"Use and Effectiveness of Intraperitoneal Chemotherapy for Treatment of Ovarian Cancer","volume":"33","author":"Wright AA","year":"2015","journal-title":"J Clin Oncol"},{"issue":"5","key":"ref8","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1080\/02656736.2017.1291999","article-title":"Drugs, doses, and durations of intraperitoneal chemotherapy standardising HIPEC and EPIC for colorectal, appendiceal, gastric, ovarian peritoneal surface malignancies and peritoneal mesothelioma","volume":"33","author":"Lemoine L","year":"2017","journal-title":"Int J Hyperthermia"},{"issue":"1","key":"ref9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/10717544.2020.1862364","article-title":"Simulating drug penetration during hyperthermic intraperitoneal chemotherapy","volume":"28","author":"L\u00f6ke DR","year":"2021","journal-title":"Drug Deliv"},{"issue":"14","key":"ref10","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.18632\/oncotarget.26667","article-title":"Body surface area-based versus concentration-based intraperitoneal perioperative chemotherapy in a rat model of colorectal peritoneal surface malignancy pharmacologic guidance towards standardization","volume":"10","author":"Lemoine L","year":"2019","journal-title":"Oncotarget"},{"issue":"7","key":"ref11","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1002\/jso.25437","article-title":"Body surface area-based vs concentration-based perioperative intraperitoneal chemotherapy after optimal cytoreductive surgery in colorectal peritoneal surface malignancy treatment COBOX trial","volume":"119","author":"Lemoine L","year":"2019","journal-title":"J Surg Oncol"},{"issue":"8","key":"ref12","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.3390\/cells9081775","article-title":"The Temperature-Dependent Effectiveness of Platinum-Based Drugs Mitomycin-C and 5-FU during Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Colorectal Cancer Cell Lines","volume":"9","author":"Helderman RF","year":"2020","journal-title":"Cells"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"S758","DOI":"10.1245\/s10434-015-4853-0","article-title":"A Temperature of 40\u00b0C Appears to be a Critical Threshold for Potentiating Cytotoxic Chemotherapy In Vitro and in Peritoneal Carcinomatosis Patients Undergoing HIPEC","volume":"22","author":"Schaaf L","year":"2015","journal-title":"Ann Surg Oncol"},{"issue":"9","key":"ref14","doi-asserted-by":"crossref","first-page":"1734","DOI":"10.1016\/j.ejso.2019.03.036","article-title":"Systemic inflammatory response after hyperthermic intraperitoneal chemotherapy (HIPEC) The perfusion protocol matters!","volume":"45","author":"Roth L","year":"2019","journal-title":"Eur J Surg Oncol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"869","DOI":"10.2147\/CMAR.S153327","article-title":"Neoadjuvant chemotherapy followed by fast-track cytoreductive surgery plus short-course hyperthermic intraperitoneal chemotherapy (HIPEC) in advanced ovarian cancer preliminary results of a promising all-in-one approach","volume":"9","author":"Batista TP","year":"2017","journal-title":"Cancer Manag Res"},{"issue":"5","key":"ref16","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1007\/s00268-015-3366-0","article-title":"Where Oncologic and Surgical Complication Scoring Systems Collide Time for a New Consensus for CRS\/HIPEC","volume":"40","author":"Lehmann K","year":"2016","journal-title":"World J Surg"},{"issue":"2","key":"ref17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1093\/annonc\/mdx754","article-title":"OV21\/PETROC a randomized Gynecologic Cancer Intergroup phase II study of intraperitoneal versus intravenous chemotherapy following neoadjuvant chemotherapy and optimal debulking surgery in epithelial ovarian cancer","volume":"29","author":"Provencher DM","year":"2018","journal-title":"Ann Oncol"},{"key":"ref18","article-title":"Quality of life in a phase 2 trial of short-course hyperthermic intraperitoneal chemotherapy (HIPEC) at interval debulking surgery for high tumor burden ovarian cancer","volume":"47","author":"Lustosa RJC","year":"2020","journal-title":"Rev Col Bras Cir"},{"issue":"23","key":"ref19","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.1200\/JCO.19.00594","article-title":"Cost Effectiveness of Interval Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy in Stage III Ovarian Cancer on the Basis of a Randomized Phase III Trial","volume":"37","author":"Koole SN","year":"2019","journal-title":"J Clin Oncol"},{"key":"ref20","first-page":"47","article-title":"Health-related quality of life after interval cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with stage III ovarian cancer","author":"Koole SN","year":"2021","journal-title":"Eur J Surg Oncol"},{"issue":"11","key":"ref21","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1136\/ijgc-2020-001640","article-title":"Randomized trial of primary debulking surgery versus neoadjuvant chemotherapy for advanced epithelial ovarian cancer (SCORPION-NCT01461850)","volume":"30","author":"Fagotti A","year":"2020","journal-title":"Int J Gynecol Cancer"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ejca.2020.02.020","article-title":"Comparison of survival between primary debulking surgery and neoadjuvant chemotherapy for stage III\/IV ovarian, tubal and peritoneal cancers in phase III randomised trial","volume":"130","author":"Onda T","year":"2020","journal-title":"Eur J Cancer"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"S971","DOI":"10.1245\/s10434-015-4623-z","article-title":"Neoadjuvant Chemotherapy Followed by Interval Debulking Surgery and the Risk of Platinum Resistance in Epithelial Ovarian Cancer","volume":"22","author":"da Costa AA","year":"2015","journal-title":"Ann Surg Oncol"},{"issue":"10","key":"ref24","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.1016\/0006-2952(90)90733-2","article-title":"Activation of programmed cell death (apoptosis) by cisplatin, other anticancer drugs, toxins and hyperthermia","volume":"40","author":"Barry MA","year":"1990","journal-title":"Biochem Pharmacol"},{"issue":"4","key":"ref25","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1245\/s10434-014-4096-5","article-title":"Postoperative time course and utility of inflammatory markers in patients with ovarian peritoneal carcinomatosis treated with neoadjuvant chemotherapy, cytoreductive surgery, and HIPEC","volume":"22","author":"Medina Fern\u00e1ndez FJ","year":"2015","journal-title":"Ann Surg Oncol"},{"issue":"13","key":"ref26","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1200\/JCO.2014.55.9898","article-title":"Long-term survival advantage and prognostic factors associated with intraperitoneal chemotherapy treatment in advanced ovarian cancer a gynecologic oncology group study","volume":"33","author":"Tewari D","year":"2015","journal-title":"J Clin Oncol"},{"issue":"8","key":"ref27","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1200\/JCO.2014.56.3106","article-title":"Does aggressive surgery improve outcomes Interaction between preoperative disease burden and complex surgery in patients with advanced-stage ovarian cancer: an analysis of GOG 182","volume":"33","author":"Horowitz NS","year":"2015","journal-title":"J Clin Oncol"},{"issue":"4","key":"ref28","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.3390\/jcm9041235","article-title":"Rethinking Radical Surgery in Interval Debulking Surgery for Advanced-Stage Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy","volume":"9","author":"Lee YJ","year":"2020","journal-title":"J Clin Med"},{"issue":"24","key":"ref29","doi-asserted-by":"crossref","first-page":"9851","DOI":"10.1073\/pnas.1101053108","article-title":"Mild hyperthermia inhibits homologous recombination, induces BRCA2 degradation, and sensitizes cancer cells to poly (ADP-ribose) polymerase-1 inhibition","volume":"108","author":"Krawczyk PM","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"key":"ref30","first-page":"672873","article-title":"Hyperthermia Versus Oncothermia Cellular Effects in Complementary Cancer Therapy","volume":"2013","author":"Hegyi Gabriella","year":"2013","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref31","first-page":"666","article-title":"Can HIPEC be used against platinum-resistance and for inducing sensitivity to PARP inhibitors in ovarian cancer","volume":"3","author":"Batista TP","year":"2020","journal-title":"Cancer Drug Resist"},{"issue":"2","key":"ref32","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ygyno.2018.11.008","article-title":"Early tumor regrowth is a contributor to impaired survival in patients with completely resected advanced ovarian cancer An exploratory analysis of the Intergroup trial AGO-OVAR 12","volume":"152","author":"Heitz F","year":"2019","journal-title":"Gynecol Oncol"},{"issue":"3","key":"ref33","doi-asserted-by":"crossref","DOI":"10.3802\/jgo.2020.31.e34","article-title":"Microscopic diseases remain in initial disseminated sites after neoadjuvant chemotherapy for stage III\/IV ovarian, tubal, and primary peritoneal cancer","volume":"31","author":"Tate S","year":"2020","journal-title":"J Gynecol Oncol"},{"issue":"1","key":"ref34","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3390\/jcm10010041","article-title":"Microscopic Peritoneal Residual Disease after Complete Macroscopic Cytoreductive Surgery for Advanced High Grade Serous Ovarian Cancer","volume":"10","author":"Aza\u00efs H","year":"2020","journal-title":"J Clin Med"},{"issue":"1","key":"ref35","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1080\/02656736.2021.1945688","article-title":"Hyperthermic intraperitoneal chemotherapy enhances antitumor effects on ovarian cancer through immune-mediated cancer stem cell targeting","volume":"38","author":"Wu CC","year":"2021","journal-title":"Int J Hyperthermia"}],"container-title":["Revista do Col\u00e9gio Brasileiro de Cirurgi\u00f5es"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rcbc\/v49\/0100-6991-rcbc-49-e20223135.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T22:14:58Z","timestamp":1646172898000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0100-69912022000100206&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":35,"alternative-id":["S0100-69912022000100206"],"URL":"https:\/\/doi.org\/10.1590\/0100-6991e-20223135","relation":{},"ISSN":["1809-4546","0100-6991"],"issn-type":[{"value":"1809-4546","type":"electronic"},{"value":"0100-6991","type":"print"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"e20223135"}}