Ovarian cancer is often detected at an advanced stage, making treatment both challenging and crucial. With modern surgical and therapeutic advancements, approaches like Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are offering new hope for patients.

What is Advanced-Stage Ovarian Cancer?

Ovarian cancer that has spread beyond the pelvis to other areas of the abdomen and/or lymph nodes is considered advanced stage (Stage III) disease. At this stage, treatment focuses on reducing the tumor burden and controlling disease progression to improve survival and quality of life.

What is Cytoreductive Surgery (CRS)?

Cytoreductive surgery is a specialized operation designed to remove as much visible cancer as possible from the abdominal cavity.

• The surgeon removes tumor deposits from the abdomen, including the peritoneum (the inner lining of the abdomen) and, if necessary, affected portions of the bowel.
• The primary goal is to leave no visible tumor behind, as the amount of residual disease directly influences treatment outcomes.

What is HIPEC?

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is an advanced treatment performed immediately after CRS, during the same surgery.

• Once all visible tumors are removed, heated chemotherapy (41.5°C or above) is circulated throughout the abdominal cavity for about 90 minutes.
• The combination of heat and chemotherapy enhances the destruction of microscopic cancer cells that may remain on abdominal surfaces.
• This method allows for direct targeting of cancer cells, with reduced systemic side effects compared to traditional chemotherapy.

Why Use CRS + HIPEC in Advanced Ovarian Cancer?

The combination of Cytoreductive Surgery and HIPEC offers a powerful two-step approach:

• ✅ Removes bulky visible tumors
• ✅ Destroys remaining microscopic cancer cells
• ✅ Improves treatment outcomes – clinical studies suggest this combination can increase survival rates and delay recurrence in carefully selected patients

Key Takeaway

CRS + HIPEC is considered an aggressive yet effective approach for patients with advanced ovarian cancer limited to the abdomen. While it is not suitable for everyone, a detailed consultation with a surgical oncologist is essential to understand the potential benefits, risks, and manageable complications of this treatment.

Dr Nataraj Naidu R
MS (General Surgery), DNB (Surgical Oncology), FMAS, FAIS, FICRS
Consultant – Surgical Oncologist and Robotic surgeon