CLINICAL CASES OF COMPREHENSIVE TREATMENT OF OVARIAN CANCER USING HYPERTHERMIC INTRAPERITONEAL CHEMOPERFUSION (HIPEC)

Abstract

Relevance: Ovarian cancer remains one of the most lethal malignancies of the female reproductive system due to late diagnosis and a high rate of recurrence. Even after optimal cytoreduction, microscopic peritoneal implants often persist, leading to poor five-year survival outcomes. Hyperthermic intraperitoneal chemoperfusion (HIPEC) is considered a promising locoregional treatment modality that enhances therapeutic efficacy through the destruction of micrometastases and increased sensitivity to platinum-based agents. International studies demonstrate improvements in overall and progression-free survival with the use of CRS + HIPEC; however, in Kazakhstan, clinical experience with this method remains limited, making the analysis of clinical cases particularly relevant.

The study aimed to analyze the specifics of management and outcomes of complex treatment of advanced ovarian cancer using cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion in the clinical practice of Kazakhstan.

Methods: The article describes clinical cases of three patients with advanced ovarian cancer. Following imaging and histological confirmation, the patients received 3–4 cycles of neoadjuvant polychemotherapy, underwent interval complete cytoreductive surgery (CC-0), and subsequently HIPEC with cisplatin (130–150 mg). Treatment efficacy was assessed by computed tomography and serum CA-125 levels.

Results: In all three cases, optimal cytoreduction was performed after neoadjuvant chemotherapy, followed by cisplatin-based HIPEC at a dose of 130–150 mg. The treatment achieved adequate disease control: a marked decrease in CA-125 and no signs of early progression during postoperative follow-up. The postoperative period was satisfactory, with no severe complications requiring reoperation. All patients achieved clinical stabilization of the disease.

Conclusion: The combined approach including NACT, cytoreduction, and HIPEC demonstrated both effectiveness and acceptable safety in patients with advanced ovarian cancer. All cases showed a decline in CA-125 levels and absence of early progression. These findings support the potential for wider implementation of HIPEC in clinical practice in Kazakhstan.