Current Treatment Options in Oncology

, Volume 15, Issue 1, pp 27–40

Intraperitoneal Chemotherapy from Armstrong to HIPEC: Challenges and Promise

  • Ramez N. Eskander
  • James Cripe
  • Robert E. Bristow
Gynecologic Cancers (RJ Morgan, Section Editor)

Opinion

The treatment of advanced stage ovarian, primary peritoneal and fallopian tube cancer represents a therapeutic challenge as evidenced by the 70 %–80 % recurrence rate. Our understanding of the synergy between surgical cytoreduction and effective systemic chemotherapy continues to evolve, with research supporting maximal cytoreductive effort followed by intraperitoneal chemotherapy. Specifically, analysis of phase III clinical trials has shown a median survival of 110 months in those treated with intraperitoneal chemotherapy, when surgery results in no visible residual disease. Additionally, incorporation of hyperthermic intraperitoneal chemotherapy at the time of surgical resection has gained attention as an alternate therapeutic option, in an attempt to obviate toxicities encountered with repetitive cycles of intraperitoneal chemotherapy. Currently, surgical cytoreduction in the hands of an experienced gynecologic oncologist, followed by intraperitoneal chemotherapy is thought to portend the greatest survival benefit in patients with advanced stage ovarian cancer spectrum cancers. Additional investigation regarding the oncologic outcomes and morbidity of hyperthermic intraperitoneal chemotherapy is warranted.

Keywords

HIPEC Intraperitoneal chemotherapy Cytoreductive surgery Ovarian cancer 

References and Recommended Reading

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ramez N. Eskander
    • 1
  • James Cripe
    • 1
  • Robert E. Bristow
    • 1
  1. 1.Division of Gynecologic Oncology, Department of Obstetrics and GynecologyThe University of California, Irvine Medical CenterOranceUSA

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