Ovarian cancer is the gynecological cancer with the highest mortality rate in developed countries. More than 75% of patients are diagnosed at an advanced stage of the disease, when tumor implants have already spread into the abdominal cavity, which is called peritoneal carcinomatosis. The survival rate of patients diagnosed with an advanced stage of ovarian cancer is 10-15% at 10 years and it has not improved in the last 20 years.
The standard treatment for advanced ovarian cancers is cytoreduction surgery, which involves removing all visible tumor implants within the abdominal cavity, followed by chemotherapy. Patients who cannot be operated initially, as not all tumor implants could be removed, are treated first with intravenous chemotherapy, what we call neoadjuvant treatment, to try to reduce the amount of disease and allow a surgery later on.
A recent study called “Hyperthermic Intraperitoneal Chemotherapy in Ovarian Cancer”, is a phase III, multicenter, randomized study with level of evidence I, published in the New England Journal of Medicine, which shows that these patients with an advanced stage of the disease that cannot be operated initially, but treated with intravenous chemotherapy and subsequently cytoreductive surgery plus HIPEC have a median survival of 1 year more, compared to patients who are only treated with cytoreductive surgery after chemotherapy. In this study, HIPEC consisted in applying intraperitoneal chemotherapy in this case “cisplatin”, for one hour at 40 degrees, inside the abdomen, once the complete surgery had been performed.
Currently, the possibility of applying HIPEC after a cytoreduction surgery to all patients diagnosed with ovarian cancer is being evaluated through a clinical trial.
At Quenet Torrent Institute, we insist that patients with ovarian cancer must be evaluated by a multidisciplinary committee expert in gynecologic oncology or peritoneal carcinomatosis, which will be able to advise the patient on the best treatment, offering a longer life expectancy as well as a better quality of life.