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Gynecologic Oncology

The Role of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Ovarian Cancer

James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky, USA

Key Words. Hyperthermic intraperitoneal chemotherapy (HIPEC) • Ovarian neoplasms • Intraperitoneal chemotherapy • Hyperthermia • Cytoreductive surgery

Correspondence: C. William Helm, M.B.B.Chir., F.R.C.S., F.A.C.O.G., Division of Gynecologic Oncology, Third Floor, James Graham Brown Cancer Center, 529 South Jackson Street, Louisville, Kentucky 40202, USA. Telephone: 502-561-7254; Fax: 502-561-7205; e mail: cwhelm{at}uoflobgyn.com

Received December 10, 2008; accepted for publication May 6, 2009; first published online in THE ONCOLOGIST Express on July 16, 2009.

Disclosures: C. William Helm: Honoraria: ThermaSolutions, Inc; Research funding/contracted research: ThermaSolutions, Inc, Sanofi-Aventis.

The devices discussed in this article are, to the author's knowledge, not FDA-approved for intraperitoneal delivery.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Overall outcomes for women with epithelial ovarian cancer (EOC) remain relatively poor, and superior methods of treatment are needed. EOC is a peritoneal surface malignancy that is relatively sensitive to chemotherapy agents, making it a good target for i.p. chemotherapy. Because there is strong laboratory data demonstrating the ability of hyperthermia to increase the efficacy of chemotherapeutic agents, the addition of hyperthermia to i.p. chemotherapy, hyperthermic intraperitoneal chemotherapy (HIPEC), makes theoretical sense. This article reviews the current literature and discusses the possible role for HIPEC in EOC at significant natural history time points: front line, at the time of interval debulking, in consolidation, and for recurrent disease. The conclusion is that much further research is needed but that HIPEC could sensibly be researched at all the natural history time points in EOC.