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BackgroundThe addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to interval cytoreductive surgery improves recurrence-free and overall survival in patients with FIGO stage III ovarian cancer who are ineligible for primary cytoreductive surgery. The effect of HIPEC remains undetermined in patients who are candidates for primary cytoreductive surgery.Primary objectiveThe primary objective is to evaluate the effect of HIPEC on overall survival in patients with FIGO stage III epithelial ovarian cancer who are treated with primary cytoreductive surgery resulting in no residual disease, or residual disease up to 2.5 mm in maximum dimension.Study hypothesisWe hypothesize that the addition of HIPEC to primary cytoreductive surgery improves overall survival in patients with primary FIGO stage III epithelial ovarian cancer.Trial designThis international, randomized, open-label, phase III trial will enroll 538 patients with newly diagnosed FIGO stage III epithelial ovarian cancer. Following complete or near-complete (residual disease ≤2.5 mm) primary cytoreduction, patients are randomly allocated (1:1) to receive HIPEC or no HIPEC. All patients will receive six courses of platinum-paclitaxel chemotherapy, and maintenance PARP-inhibitor or bevacizumab according to current guidelines.Major eligibility criteriaPatients with FIGO stage III primary epithelial ovarian, fallopian tube, or primary peritoneal cancer are eligible after complete or near-complete primary cytoreductive surgery. Patients with resectable umbilical, spleen, or local bowel lesions may be included. Enlarged extra-abdominal lymph nodes should be negative on FDG-PET or fine-needle aspiration/biopsy.Primary endpointThe primary endpoint is overall survival.Sample sizeTo detect a HR of 0.67 in favor of HIPEC, 200 overall survival events are required. With an expected accrual period of 60 months and 12 months additional follow-up, 538 patients need to be randomized.Estimated dates for completing accrual and presenting resultsThe OVHIPEC-2 trial started in January 2020 and primary analyses are anticipated in 2026.Trial registrationClinicalTrials.gov:NCT03772028

This article addresses a significant gap in the transformative learning literature as it relates to collective transformation, a transformation that is a level beyond individual transformation and is differentiated from the designed and imposed forms of social or organizational change. We consider collective transformation as an emergent and shared worldview shift that is grounded in a shared experience. The participants might not be fully aware of or even able to describe this experience until they engage with it at the interpersonal level. In prior research and practice, the five authors have independently observed and documented the phenomenon of collective transformation among members of marginalized populations who have undergone liminal experiences—forms of disequilibrium that leave individuals betwixt and between. The common thread in these experiences is the emergence of a shared feeling called communitas, which is a deeply felt (yet often temporary) sense of belonging and community. This study’s purpose is to further explore the roles that states of liminality and communitas play in creating the conditions for collective transformation. We draw on several theoretical and practice-based areas of literature and on five particular types of experience. We then examine each case for shared experiences of liminality and communitas as well as for the underlying qualities of self-understanding, relational ability, and a collectively felt sense of new possibilities. This study also includes suggestions for the application of these concepts to other social groups and in other contexts.

Social reintegration of veterans following military service is a complex, nonlinear, and highly individualized phenomenon, yet much of the existing literature on transition of veterans represents a narrow and limited perspective of transition and trauma—mostly written from an external (nonveteran) perspective. We present an alternative based on concepts of personal and social transformation through collaborative, veteran-led social science research designed from an interdisciplinary Adlerian (social systems) perspective. Participants are military-connected students, defined as service members, veterans, family members, and mental health practitioners experienced in working with military and veteran populations. Research projects described were designed by the students, and these typically involved informal data gathering and self-reflection, combined with extensive review of current interdisciplinary literature in the military psychology field. A case study of informal participative research with a cohort of female Navy Chief Petty Officers by the first author is presented as an example. Conclusions and recommendations support further extension of this cohort-driven adult learning model as a means of combining personal growth and social transformation by including military, veteran, and family perspectives in research and literature directed toward veterans’ social and mental health programs and policies.