González Bayón, Luis AndrésSteiner, M.A.Vásquez Jiménez, W.Asencio Pascual, José ManuelÁlvarez de la Sierra, P.Atahualpa Arenas, F.Rodríguez del Campo, J.García Sabrido, José Luis2025-10-162025-10-162013-07-17L. Gonzalez Bayon, M.A. Steiner, W. Vasquez Jimenez, J.M. Asencio, P. Alvarez de Sierra, F. Atahualpa Arenas, J. Rodriguez del Campo, J.L. Garcia Sabrido, Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial ovarian carcinoma: Upfront therapy, at first recurrence, or later?, European Journal of Surgical Oncology (EJSO), Volume 39, Issue 10, 2013, Pages 1109-1115, ISSN 0748-7983, https://doi.org/10.1016/j.ejso.2013.06.022.0748-798310.1016/j.ejso.2013.06.022https://hdl.handle.net/20.500.14352/124989Aim Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) has been proposed as treatment for advanced epithelial ovarian carcinoma (EOC). No consensus exists on when to administer CRS + HIPEC during the natural history of the disease, namely, as upfront therapy, at first recurrence, or at second or subsequent recurrence. Patients and methods We analyzed a series of patients with advanced EOC collected prospectively in an institution with a peritoneal malignant disease treatment program. Patients were treated with CRS + HIPEC upfront, at first recurrence, and at second or subsequent recurrence. Results We treated 42 patients: 15 upfront, 19 at first recurrence, and 8 at second or subsequent recurrence. Cytoreduction was complete (CC0) in 75% of cases; residual disease was <2.5 mm (CC1) in 25%. Severe morbidity (CTCAE v.3.0, grade 3–4) was 26%, and hospital mortality was 7%. After a median follow-up of 24 months, median overall survival was 77.8 months for patients treated upfront, 62.8 months for patients treated at first recurrence, and 35.7 months for patients treated at second or subsequent recurrence. Disease-free survival was 21.1 months, 18 months, and 5.7 months, respectively. Overall survival in the upfront and first recurrence groups was similar, and statistically significant differences with the second recurrence group were identified (p < 0.03). Conclusions Treatment of advanced EOC using CRS + HIPEC is promising in terms of overall survival and disease-free survival when administered as upfront and at first recurrence therapy. These results warrant further evaluation in a randomized trial.engjournal article1532-2157https://doi.org/10.1016/j.ejso.2013.06.022https://www.sciencedirect.com/science/article/pii/S0748798313004605restricted access617Advanced epithelial ovarian carcinomaCytoreductive surgeryHyperthermic intraperitoneal chemotherapyUpfront therapyFirst recurrence therapySecond or subsequent recurrence therapyCirugía3213.01 Cirugía Abdominal