Is minimal invasive surgical treatment of ovarian cancer plus HIPEC a utopia? A review of the literature

The purpose of this study is to evaluate the effectiveness and safety of Hyperthermic Intraperitoneal Chemotherapy (HIPEC) approached by minimally invasive surgical (MIS) techniques. We conducted a systematic review of the published relevant studies and evaluated a total of 403 patients, with a median age of 57 years old (20–69). The histology of the patients included 160 (39.7%) patients with pseudomyxoma peritonei, 43 (10.6%) with mesothelioma peritonei, 37 (9.2%) with epithelial ovarian cancer (EOC), 80 (19.8%) with appen-diceal cancer and 26 (6.4%) with colon cancer, while the histology of the rest of the patients was not specified in the studies. The median Periotoneal Cancer Index (PCI) was 4 (1–10) and complete cytoreduction (R0) was achieved in 239 patients (60%). 145 (36%) of the patients underwent omentectomy, 37 patients (9.2%) under-went cecum/right colectomy, 41 patients (10.1%) underwent salpingovariectomy, 6 (1.5%) small bowel resection, 28 (6.7%) peritonectomies, in 9 (2.2%) sigmoeidectomy and 107 (26.5%) appendectomy, with a mean operative time of 240 min (90–510). Conversion to laparotomywas performed in 13 (3.2%) cases, while in 32 (7.9%) an intestinal anastomosis or suture was required. The median length of stay was 4.5 days (3–6) and the median follow-up of the patients was 13.5 months (1–72). We concluded that minimal invasive surgery can be considered as an approach in the application of hyperthermic intraperitoneal chemotherapy. Further large studies with higher quality data are warranted to verify our findings.

Hyperthermic intraperitoneal chemotherapy; HIPEC; Minimal invasive surgery; MIS; Laparoscopic

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