HIPEC in ovarian cancer: treatment of a new era or is it the end of the pipeline?

Gynecol Oncol. 2015 Nov;139(2):363-8. doi: 10.1016/j.ygyno.2015.06.012. Epub 2015 Jun 16.

Abstract

Ovarian cancer is the leading cause of death from gynecological cancer in western countries. The absence of an effective screening program as well as specific symptoms, makes the diagnosis difficult and often made in advanced stages of the disease, in the presence of peritoneal dissemination. The complete cytoreduction of the disease and tumor sensitivity to systemic chemotherapy based on platinums, are the two main prognostic factors. However in patients with complete cytoreduction the recurrence rate is high. The microscopic component of the disease at the end of the cytoreduction is responsible for these recurrences and the use of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) in the same time of surgery has been proposed as a reasonable therapeutic option for treatment. However, the absence of sufficient levels of scientific evidence to support the use of HIPEC in patients with ovarian cancer with peritoneal dissemination does not allow a general recommendation outside of clinical trials. The main objective of this study is to identify the strengths and weaknesses of HIPEC treatment in ovarian cancer with peritoneal dissemination, and to know which points can be improved in the future.

Keywords: Cytoreduction; HIPEC; Ovarian cancer; Peritoneal surface malignancies; Postoperative intraperitoneal chemotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Carcinoma / secondary
  • Carcinoma / therapy*
  • Cytoreduction Surgical Procedures
  • Female
  • Humans
  • Hyperthermia, Induced / methods*
  • Infusions, Parenteral
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy*
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents