The rise of HIPEC in ovarian cancer treatment: Are we still there?
Year: 2025
Type: article
Abstract: Over the past decade, the treatment landscape for ovarian cancer in India has evolved significantly. One of the most notable advancements is the introduction of Hyperthermic Intraperitoneal Chemotherapy (HIPEC). HIPEC is a cutting-edge treatment that combines heated chemotherapy drugs with a surgical procedure to treat peritoneal carcinomatosis (a common metastatic feature of ovarian cancer). Traditionally, ovarian cancer treatment in India involved standard chemotherapy and surgical approaches, but the advent of HIPEC has dramatically improved outcomes for patients with advanced stages of the disease. This article explores how HIPEC has changed the role of ovarian cancer treatment in India, offering new hope for women with late-stage ovarian cancer.[1] TRADITIONAL TREATMENT MODALITIES FOR OVARIAN CANCER IN INDIA Before the adoption of HIPEC, the treatment of ovarian cancer in India followed the global standard approach of surgery followed by chemotherapy. Surgical removal of the tumor, also known as debulking surgery, aimed to reduce the tumor burden, but complete removal was often not possible in advanced stages due to peritoneal spread. Chemotherapy was then used to target the remaining cancer cells. However, these treatments had limitations, especially in patients with widespread peritoneal disease. The success rates of survival, particularly for women diagnosed at advanced stages (stages III and IV), remained low. Many patients experienced recurrence after standard chemotherapy, highlighting the need for more effective and localized treatment options. It is in this context that HIPEC emerged as a transformative therapy. HOW HIPEC WORKS: A NOVEL APPROACH HIPEC is a combination of cytoreductive surgery (CRS) and intraperitoneal chemotherapy. In the procedure, after the tumor is surgically removed, heated chemotherapy drugs are infused directly into the abdominal cavity. The heat enhances the efficacy of the chemotherapy drugs and allows for better penetration of the chemotherapy into the tissues affected by cancer. The procedure is usually done under general anesthesia and lasts for several hours. The chemotherapy is circulated in the abdominal cavity for about 90 minutes before being drained. The key advantage of HIPEC is its ability to directly target cancer cells within the peritoneal cavity, where ovarian cancer often spreads. This localized treatment minimizes systemic side effects and can lead to more effective elimination of cancer cells that would be difficult to treat with conventional chemotherapy alone.[2-4] IMPACT ON OVARIAN CANCER OUTCOMES IN INDIA The introduction of HIPEC has had a profound impact on the treatment outcomes for ovarian cancer in India, particularly for those with advanced-stage disease. Studies have shown that HIPEC can improve overall survival and progression-free survival rates when combined with optimal cytoreductive surgery. For patients who had previously faced limited treatment options due to the widespread nature of the disease, HIPEC offers a chance for more aggressive treatment and improved long-term outcomes. In India, where ovarian cancer is often diagnosed at an advanced stage due to late detection and limited awareness, HIPEC provides a more targeted approach. The survival benefit is especially significant for women who have undergone initial surgery but still have residual cancer. The enhanced delivery of chemotherapy directly to the affected areas allows for more thorough treatment and can prevent recurrence, which is a major concern in traditional chemotherapy.[1-5] ACCESSIBILITY AND CHALLENGES IN INDIA Despite the promise of HIPEC, its accessibility in India remains limited. While several advanced cancer centers in metropolitan areas like Delhi, Mumbai, and Bangalore have adopted HIPEC, the treatment is still not widely available in smaller cities and rural areas. The cost of the procedure is another significant barrier for many patients, as HIPEC requires specialized equipment, a team of experienced surgeons, and extended hospital stays. Moreover, the lack of widespread awareness among both healthcare providers and patients means that many women may not be aware of this advanced treatment option. Education and awareness campaigns are needed to inform patients about the availability of HIPEC and its potential benefits.[1-5] FUTURE PROSPECTS AND RESEARCH As more hospitals and cancer centers in India adopt HIPEC for ovarian cancer, its availability is expected to increase. Continued research into refining the procedure and improving patient selection criteria will likely improve its efficacy and reduce costs, making it more accessible to a broader population. Furthermore, combining HIPEC with other cutting-edge therapies such as immunotherapy and targeted treatments may open new avenues for more personalized and effective treatment strategies. CONCLUSION HIPEC has revolutionized the treatment of advanced ovarian cancer in India by offering a more effective and localized approach to chemotherapy. For women with peritoneal spread or recurrent disease, HIPEC provides a significant survival benefit and improves the chances of remission. While its availability is still limited to certain regions, the potential for widespread adoption in the coming years is promising. As awareness increases and accessibility improves, HIPEC has the potential to transform ovarian cancer care across India, offering new hope to women battling this deadly disease. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Authors: Rohan Kapoor, M. D. Ray
Institution: All India Institute of Medical Sciences
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4409116798