Аннотация
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, resulting in poor five-year survival. Hyperthermic intraperitoneal chemoperfusion (HIPEC) is a promising locoregional treatment modality that enhances therapeutic efficacy by destroying micrometastases and increasing sensitivity to platinum-based agents. International studies demonstrate improvements in overall and progression-free survival with the use of cytoreductive surgery (CRS) + HIPEC; however, in Kazakhstan, clinical experience with this method remains limited, making the analysis of clinical cases particularly relevant. The study aimed to present the outcomes of comprehensive treatment of advanced ovarian cancer using cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion and to describe management features and clinical results 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 (NAPCT) and underwent interval complete CRS (CC-0), followed by 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 achieved after neoadjuvant chemotherapy, followed by cisplatin-based HIPEC at 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 NAPCT, CRS, and HIPEC, demonstrated both effectiveness and acceptable safety in patients with advanced ovarian cancer. All cases showed a decline in CA-125 levels and no early progression. These findings support the potential for wider implementation of HIPEC in clinical practice in Kazakhstan.