Article Data

  • Views 965
  • Dowloads 167

Case Reports

Open Access Special Issue

CRS and HIPEC in a patient with recurrent ovarian cancer after PDS and adjuvant chemotherapy, a case report and MDT discussion

  • Alexandros Fotiou1,*,
  • Victoria Psomiadou1
  • Anastasia Prodromidou1
  • Christos Iavazzo1

1Department of Gynecological Oncology, Metaxa Memorial Cancer Hospital, 18537 Piraeus, Greece

DOI: 10.31083/j.ejgo4302043 Vol.43,Issue 2,April 2022 pp.368-371

Submitted: 17 March 2021 Accepted: 12 April 2021

Published: 15 April 2022

(This article belongs to the Special Issue Hyperthermic Intraperitoneal Chemotherapy to Gynaecological Oncology)

*Corresponding Author(s): Alexandros Fotiou E-mail:


Background: Ovarian cancer is the most lethal gynecologic malignancy worldwide and is plagued by a high recurrence rate. Cytoreductive surgery and adjuvant chemotherapy are considered the gold standard treatment for advanced ovarian cancer patients. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a relatively new option, especially for patients with peritoneal and recurrent disease. Case: We intend to present a case of a patient with recurrent ovarian cancer managed initially with primary debulking surgery plus adjuvant chemotherapy and afterward with secondary cytoreduction and HIPEC. Conclusion: Complete cytoreduction remains the ultimate goal in the surgical treatment of patients with advanced stage ovarian cancer. Moreover, patients would benefit from the use of HIPEC after the optimal cytoreduction, especially in those with peritoneal metastases. Several studies have shown the utility of HIPEC regarding disease-free and overall survival after extended debulking surgery.


Cytoreductive surgery; HIPEC; Recurrent ovarian cancer

Cite and Share

Alexandros Fotiou,Victoria Psomiadou,Anastasia Prodromidou,Christos Iavazzo. CRS and HIPEC in a patient with recurrent ovarian cancer after PDS and adjuvant chemotherapy, a case report and MDT discussion. European Journal of Gynaecological Oncology. 2022. 43(2);368-371.


[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA: A Cancer Journal for Clinicians. 2020; 70: 7–30.

[2] Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics. 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018; 68: 394–424.

[3] Vergote I, Tropé CG, Amant F, Kristensen GB, Ehlen T, Johnson N, et al. Neoadjuvant chemotherapy or primary surgery in stage IIIC or IV ovarian cancer. New England Journal of Medicine. 2010; 363: 943–953.

[4] Tsonis O, Gkrozou F, Vlachos K, Paschopoulos M, Mitsis MC, Zakynthinakis-Kyriakou N, et al. Upfront debulking surgery for high-grade serous ovarian carcinoma: current evidence. Annals of Translational Medicine. 2020; 8: 1707.

[5] van Driel WJ, Koole SN, Sikorska K, Schagen van Leeuwen JH, Schreuder HWR, Hermans RHM, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. New England Journal of Medicine, 2018; 378: 230–240.

[6] Iavazzo C, Fotiou A, Tsiatas M, Christopoulou A, Spiliotis J, Sugarbaker P. Survey on the current gynaecological approach of ovarian cancer patients: the utility of HIPEC. Pleura and Peritoneum. 2020; 5: 20190029.

[7] Spiliotis J, Iavazzo C, Fotiou A, Kopanakis N, Terra A, Efstathiou E, et al. Upfront or intermediate treatment of advanced ovarian cancer patients with cytoreduction plus HIPEC: results of a retrospective study. Journal of Surgical Oncology. 2021; 123: 630–637.

[8] Vergote I, Harter P, Chiva L. Hyperthermic intraperitoneal chemotherapy does not improve survival in advanced ovarian cancer. Cancer. 2019; 125: 4594–4597.

[9] Harter P, du Bois A, Sehouli J, Mahner S, Vergote I, Chiva L, et al. Is there a role for HIPEC in ovarian cancer? Archives of Gynecology and Obstetrics. 2018; 298: 859–860.

[10] Vergote I, Chiva L, du Bois A. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. New England Journal of Medicine. 2018; 378: 1362–1363.

[11] Rassy E, Assi T, Boussios S, Kattan J, Smith-Gagen J, Pavlidis N. Narrative review on serous primary peritoneal carcinoma of unknown primary site: four questions to be answered. Annals of Translational Medicine. 2020; 8: 1709.

[12] Spiliotis J, Halkia E, Lianos E, Kalantzi N, Grivas A, Efstathiou E, et al. Cytoreductive surgery and HIPEC in recurrent epithelial ovarian cancer: a prospective randomized phase III study. Annals of Surgical Oncology. 2015; 22: 1570–1575.

[13] Wright AA, Bohlke K, Armstrong DK, Bookman MA, Cliby WA, Coleman RL, et al. Neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer: society of gynecologic oncology and American society of clinical oncology clinical practice guideline. Journal of Clinical Oncology. 2016; 34: 3460–3473.

[14] Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. New England Journal of Medicine. 2006; 354: 34–43.

[15] Iavazzo CR, Kopanakis ND, Spiliotis JD. Hyperthermic intraperitoneal chemotherapy for ovarian cancer: peritoneal surface disease severity score-preliminary results. Journal of Surgical Oncology. 2018; 118: 591–592.

[16] Hotouras A, Desai D, Bhan C, Murphy J, Lampe B, Sugarbaker PH. Heated IntraPEritoneal Chemotherapy (HIPEC) for patients with recurrent ovarian cancer: a systematic literature review. International Journal of Gynecological Cancer. 2016; 26: 661–670.

[17] Boussios S, Sadauskaite A, Kanellos F S, et al. Neoadjuvant, HIPEC and maintenance treatment in ovarian and peritoneal serous cancer: current status. Gynecology and Pelvic Medicine. 2020; 3: 19.

[18] Spiliotis J, Iavazzo C, Sugarbaker P. Management of patients with advanced ovarian cancer—role of complete cytoreduction and HIPEC: attitudes of gynaecologist oncologists in two different continents. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2021; 61: E1–E2.

[19] Zhang G, Zhu Y, Liu C, Chao G, Cui R, Zhang Z. The prognosis impact of hyperthermic intraperitoneal chemotherapy (HIPEC) plus cytoreductive surgery (CRS) in advanced ovarian cancer: the meta-analysis. Journal of Ovarian Research. 2019; 12: 33.

[20] Lim MC, Chang S, Yoo HJ, Nam B, Bristow R, Park S. Randomized trial of hyperthermic intraperitoneal chemotherapy (HIPEC) in women with primary advanced peritoneal, ovarian, and tubal cancer. Journal of Clinical Oncology. 2017; 35: 5520.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Submission Turnaround Time