Intraperitoneal chemotherapy in ovarian cancer: who and when?

Intraperitoneal chemotherapy in ovarian cancer has been studied for several years and developed in many countries. However, despite positive results from well-conducted clinical trials, its clinical application is still controversial. A review of recent advances is presented.

Intraperitoneal chemotherapy has been studied in two situations: in the first line, combined with intravenous chemotherapy, or as a consolidation treatment, after surgery and systemic chemotherapy. In the first line, two randomized studies showed an increased survival in patients with intraperitoneal chemotherapy. In patients with pathological complete remission, the theoretical principle remains valid, treating minimal disease, but definitive results from randomized studies are lacking.

Intraperitoneal chemotherapy is a regional treatment for ovarian cancer. Its development is limited by the reluctance of the medical oncologist community to include this technique in the whole strategy of treatment, despite positive results. However, intraperitoneal chemotherapy should be considered in patients optimally debulked and with minimal residual disease.