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Update on the management and the role of intraperitoneal chemotherapy for ovarian cancer

Teo, Melissa C.C.a,b,c,d,e,f

Current Opinion in Obstetrics and Gynecology: February 2014 - Volume 26 - Issue 1 - p 3–8
doi: 10.1097/GCO.0000000000000034
GYNECOLOGIC CANCER: Edited by Anne O. Rodriguez

Purpose of review Ovarian cancer is the commonest gynaecological cancer and the fifth leading cause of cancer death in women worldwide. The majority of patients with ovarian cancer present at an advanced stage, and up to 70% of those treated with a curative approach eventually recur and succumb to their disease. This article examines the management of ovarian cancer over the years and the role of intraperitoneal chemotherapy in the treatment algorithm.

Recent findings The surgical paradigm for ovarian cancer has changed and the goal is optimal cytoreduction with no residual disease. Intraperitoneal chemotherapy has been found to be superior to intravenous treatment alone, and the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has produced encouraging results with improved disease-free and overall survivals at acceptable morbidity and mortality rates.

Summary The most important prognostic factor for ovarian cancer survival is the ability to achieve optimal cytoreduction with no residual disease. CRS and HIPEC should be considered as an option for the management of advanced ovarian cancer and further trials are required to determine its role in both the primary and recurrent settings.

aCentre for Peritoneal and Pelvic Disease

bDepartment of Surgical Oncology, National Cancer Centre (S)

cDepartment of General Surgery, Singapore General Hospital

dDepartment of Gynaecologic Oncology, KKWCH

eDuke-NUS Graduate Medical School

fYong Loo Lin School of Medicine

Correspondence to Melissa C.C. Teo, MBBS, FRCS, FAMS, MPH, Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, Singapore 169610, Singapore. Tel: +65 6436 8283/8294; e-mail: Melissa.Teo.C.C@nccs.com.sg

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins