Hipec in Ovarian Cancer. Why is it Still the Ugly Duckling of Intraperitoneal Therapy?

If one was a surgeon who believed in postoperative systemic chemotherapy, one’s argument would be based on the results of the study GOG 172 (which coincided with a clinical alert from the NCI of the United States in favor of this modality of intraperitoneal treatment after optimal surgery in patients with ovarian cancer) [1]. According to the paper published by Armstrong et al, our relative would have a median global survival of more than 65.6 months. However, the possibilities of successfully accomplishing the protocol would be very low (42%) as a result of severe systemic complications related to the treatment, even if there were no problems with the infusion catheter. In addition, several modified protocols have been reported in order to reduce problems as those seen in the GOG 172 study but actually IP/ IV chemotherapy use in clinical practice is an underused strategy to improve ovarian cancer outcomes.