Epithelial ovarian cancer (EOC) causes 60% of
ovarian cancer cases and is the fourth most common cause of death from
cancer in women. The standard of care for EOC includes a combination of surgery followed by intravenous
chemotherapy. Intraperitoneal (IP)
chemotherapy (CT) has been introduced into the therapeutic algorithm of EOC with positive results. To explore existing results regarding intraperitoneal
chemotherapy a systematic review of the literature and an analysis of our own institutional prospective database of patients treated with
cytoreductive surgery plus
hyperthermic intraperitoneal chemotherapy (
HIPEC) for EOC at different stages were conducted. The focused report concerning our personal experience with advanced EOC treated with
cytoreductive surgery and
HIPEC produced the following results: In 57 patients
cisplatin +
paclitaxel as
HIPEC was the only significant factor improving overall survival (OS) at multivariate analysis (OR 6.54, 95% CI: 1.24-34.47, P=0.027). Patients treated with
HIPEC cisplatin +
paclitaxel showed a median OS of 46 months (SD 6.4, 95% CI: 33.4-58.6), while patients treated with other
HIPEC regimens showed a median OS of 12 months (SD 3.1, 95% CI: 6.0-18.0). The 2y-OS was 72% and 3y-OS was 68% for
cisplatin +
paclitaxel as
HIPEC, while the 2y- and 3y-OS was 0% for other
HIPEC regimens. Patients treated with
HIPEC cisplatin +
paclitaxel showed a median disease-free survival (DFS) of 13 months (SD 1.6, 95% CI: 9.9-16.1), while patients treated with other
HIPEC regimens showed a median DFS of 8 months (SD 3.1, 95% CI: 1.9-14.1). In conclusion,
HIPEC cisplatin +
paclitaxel in
ovarian cancer showed positive results that may be considered semi-definitive according to the level of evidence and should be considered a starting point for further investigations. At present
HIPEC cisplatin +
paclitaxel should be proposed to patients with advanced
ovarian cancer as standard treatment at almost all stages of disease.
Platinum +
taxane-based intraperitoneal regimens demonstrated superior results compared to other regimens.