Hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of ovarian cancer

Abstract

Key content Hyperthermic intraperitoneal chemotherapy (HIPEC) at the time of cytoreductive surgery is a proposed additional treatment in the management of advanced tubo‐ovarian cancer. Additional organisational approvals, costs, changes to theatre infrastructure and pre‐, intra‐, and post‐operative management considerations are required to implement HIPEC in a clinical setting. Current meta‐analysis data suggest that in the setting of interval cytoreductive surgery, HIPEC prolongs overall survival and progression‐free survival. There is currently no evidence of benefit in the setting of primary surgery or recurrent disease, but results of ongoing clinical trials are pending. Learning objectives To understand the mechanism of action, safety and efficacy of HIPEC as an adjuvant treatment in tubo‐ovarian cancer. Ethical issues Because of variation in treatment protocols and heterogeneity of reported outcomes, HIPEC has not yet been adopted into standard practice. Further studies assessing its benefit, mainly in the setting of primary cytoreduction, are ongoing.