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Cytoreductive surgery and HIPEC seem to be associated with promising results in patients with recurrent ovarian cancer. Large international prospective studies are required to further quantify the true efficacy of HIPEC and identify the optimal treatment protocol for a maximum survival benefit.

Background State-of-the art therapy for recurrent ovarian cancer (ROC) suitable for platinum-based re-treatment includes bevacizumab-containing combinations (eg, carboplatin/paclitaxel, carboplatin/gemcitabine) or the most active non-bevacizumab regimen: carboplatin/pegylated liposomal doxorubicin (PLD). This head-to-head trial compared a standard bevacizumab-containing regimen versus carboplatin/PLD combined with bevacizumab. Methods In this multicentre, open-label, randomised, phase 3 trial, eligible patients had histologically confirmed epithelial ovarian, primary peritoneal, or fallopian tube carcinoma with first disease recurrence >6 months after first-line platinum-based chemotherapy, and were aged ≥18 years with Eastern Cooperative Oncology Group performance status 0-2. Patients were stratified by platinum-free interval, residual tumour, prior anti-angiogenic therapy, and study group language, and centrally randomised 1:1 using randomly permuted blocks of size two, four, or six to six intravenous cycles of carboplatin (AUC 4, day 1) plus gemcitabine (1000 mg/m 2 , days 1 and 8) every 3 weeks or six cycles of carboplatin (AUC 5, day 1) plus PLD (30 mg/m 2 , day 1) every 4 weeks, both given with bevacizumab (15 mg/kg every 3 weeks or 10 mg/kg every 2 weeks) until disease progression or toxicity. The primary endpoint was investigator-assessed progression-free survival (PFS). Efficacy data were analysed in the intention-to-treat population (all randomised patients). Safety was analysed in all patients who received at least one dose of study drug. This completed study is registered with ClinicalTrials.gov number NCT01837251.

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The results of the LACC trial (Laparoscopic Approach to Cervical Cancer) were first presented in a lecture given at the 49th conference of the Society of Gynecologic Oncology (SGO) held in New Orleans on March 24-27, 2018 [1]. The primary objective of this international randomized phase III multicenter study was to compare disease-free survival (DFS) rates of women who underwent laparoscopic or robotic radical hysterectomy with the DFS of women who had abdominal radical hysterectomy (TLRH/TRRH versus TARH). Secondary goals of the study included rates of recurrence , treatment-associated morbidity, overall survival, cost effectiveness, and quality of life. The trial was designed as a noninferiority study of the laparoscopic treatment arm compared to the abdominal standard-of-care arm, with a follow-up of 4.5 years and a sample size of 740 patients. Patients with primary squamous cell carcinoma, adenocarcinoma or adeno-squamous carcinoma of the uterine cervix with FIGO stage IA1 (with lymphovascular space invasion, LVSI), IA2 or IB1 disease were included in the study. Each participating center had to submit 10 documented