Hyperthermic Intraperitoneal Chemotherapy to Gynaecological Oncology

Dear Colleagues,

The role of hyperthermic intraperitoneal chemotherapy (HIPEC) as a standard treatment procedure in the field of gynecologic oncology is controversial. Although widely discussed and studied as a subsidiary method of interval cytoreductive surgery, HIPEC remains debatable even in the management of advanced and recurrent epithelial ovarian cancer. Hence, many large trials support the safety and efficacy of the method regarding the extension of overall survival in well selected EOC patients. Interestingly, encouraging findings support the effectiveness of HIPEC even performed at the time of primary debulking surgery in stage III EOC patients, by whom a complete cytoreduction is anticipated, and large ongoing trials’ results will be shortly available. The promising results of studies investigating HIPEC combined with adjuvant chemotherapy with platinum compounds in the management of advanced stage peritoneal disseminated endometrial and cervical cancer add to recent evidence and verify further more thorough research. Remarkably, peritoneal carcinomatosis from non-gynecological origin in patients with abdominally confined disease has been considered an indication for hyperthermic intraperitoneal chemotherapy. Originally in cases of pseudomyxoma peritonei and malignant peritoneal mesothelioma followed by gastric, colorectal and even breast cancer patients with pelvic peritoneal metastases, many authors have published supporting data about explorative surgery followed by cytoreduction and HIPEC.

Nevertheless, more prospective multi-center randomized studies need to be designed in order to draw safe conclusions and determine which patients could benefit from the implementation of this approach. Further issues to be determined encompass robust data of the surgical procedures, the art and dose of chemotherapeutic regimens as well as the temperature and duration of the hyperthermic arm that will warrant the optimal oncological outcome and support the recommendation of HIPEC by the gynecological cancer community.

The aim of our special issue is to publish interesting studies in the field exploring the indications, technique, future challenges. We welcome authors to submit case reports, case series, retrospective studies, randomized trials and reviews regarding the role of HIPEC in different gynecological cancers.

Prof. Dr. Christos Iavazzo, Dr. Alexandros Fotiou, Alexandros Fotiou, and Dr. Anastasia Prodromidou

Guest Editors