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State of the Science: The role of HIPEC in the treatment of ovarian cancer

Published:January 06, 2021DOI:https://doi.org/10.1016/j.ygyno.2020.12.029
      Interest in intraperitoneal (IP)-based therapies for epithelial ovarian cancer (EOC) has grown over the past decade. Yet despite multiple theoretical and clinical advantages, IP therapy has not been widely adopted in the U.S. Recently, support for hyperthermic intraperitoneal chemotherapy (HIPEC) has increased. There have been numerous retrospective studies and meta-analyses that support the use of HIPEC in ovarian cancer [
      • Lei Z.
      • Wang Y.
      • Wang J.
      • Wang K.
      • Tian J.
      • Zhao Y.
      • et al.
      Evaluation of cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for stage III epithelial ovarian cancer.
      ,
      • Classe J.M.
      • Glehen O.
      • Decullier E.
      • Bereder J.M.
      • Msika S.
      • Lorimier G.
      • et al.
      Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for first relapse of ovarian cancer.
      ,
      • Cianci S.
      • Riemma G.
      • Ronsini C.
      • De Franciscis P.
      • Torella M.
      • Schiattarella A.
      • et al.
      Hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer recurrence: systematic review and meta-analysis.
      ,
      • Bakrin N.
      • Bereder J.M.
      • Decullier E.
      • Classe J.M.
      • Msika S.
      • Lorimier G.
      • et al.
      Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients.
      ,
      • Zivanovic O.
      • Chi D.S.
      • Filippova O.
      • Randall L.M.
      • Bristow R.E.
      • O’Cearbhaill R.E.
      It’s time to warm up to hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer.
      ]. Further optimism for HIPEC was based on the recent results of a phase III trial [
      • Zivanovic O.
      • Chi D.S.
      • Filippova O.
      • Randall L.M.
      • Bristow R.E.
      • O’Cearbhaill R.E.
      It’s time to warm up to hyperthermic intraperitoneal chemotherapy for patients with ovarian cancer.
      ,
      • van Driel W.J.
      • Koole S.N.
      • Sikorska K.
      • Schagen van Leeuwen J.H.
      • HWR Schreuder
      • RHM Hermans
      • et al.
      Hyperthermic Intraperitoneal chemotherapy in ovarian cancer.
      ,
      • Koole S.N.
      • van Driel W.J.
      • Sonke G.S.
      Hyperthermic intraperitoneal chemotherapy for ovarian cancer: the heat is on.
      ,
      • Lavoué V.
      • Bakrin N.
      • Bolze P.A.
      • Bendifallah S.
      • Collinet P.
      • Graesslin O.
      • et al.
      Saved by the evidence: Hyperthermic intraperitoneal chemotherapy still has a role to play in ovarian cancer.
      ,
      • Vermorken J.B.
      • van Dam P.
      • Brand A.
      HIPEC in advanced epithelial ovarian cancer: why is there controversy?.
      ], but significant criticisms have been noted over the use of HIPEC [
      • Chiva L.M.
      • Gonzalez-Martin A.
      A critical appraisal of hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of advanced and recurrent ovarian cancer.
      ,
      • Mackay H.J.
      • Kohn E.C.
      Intraperitoneal Chemotherapy: Hot, Timely, and Relevant? Cancer.
      ,
      • Vergote I.
      • Harter P.
      • Chiva L.
      Hyperthermic intraperitoneal chemotherapy does not improve survival in advanced ovarian cancer.
      ,
      • Vergote I.
      • Harter P.
      • Chiva L.
      Is there a role for intraperitoneal chemotherapy, including HIPEC, in the management of ovarian cancer?.
      ]. Questions remain regarding optimal patient selection, drug choice, and timing of HIPEC in EOC. We review the current data of HIPEC in EOC management.

      Keywords

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