Published online Nov 10, 2013. doi: 10.5317/wjog.v2.i4.94
Revised: June 26, 2013
Accepted: August 4, 2013
Published online: November 10, 2013
Advanced stage epithelial ovarian cancer (EOC) is difficult to treat with low overall cure rates. A new strategy combining maximal cytoreductive surgery (CRS) with intra-operative hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed to treat advanced stage EOC in the primary setting. Numerous small, heterogeneous studies have been conducted exploring outcomes in patients with predominantly advanced, recurrent or refractory disease treated with CRS + HIPEC. Although morbidity rates approaching 35% have been reported, oncologic outcomes are promising. Incorporation of HIPEC for the treatment of primary EOC has continued to gain interest. Several prospective phase 2 clinical trials were recently completed evaluating the impact of CRS + HIPEC in the primary setting. This article will briefly discuss the benefits of optimal surgical cytoreduction and the theoretical basis of intraperitoneal chemotherapy in patients with advanced stage EOC, and will then review existing literature describing oncologic outcomes in EOC patients treated with HIPEC in the primary setting.
Core tip: Hyperthermic intraperitoneal chemotherapy (HIPEC), when used in combination with successful surgical cytoreduction appears to result in promising oncologic outcomes. We will eagerly await the results of the various phase 3 clinic trials, and until that time advocate the use of cytoreductive surgery + HIPEC in experienced centers under the auspices of appropriate institutional research programs.