In a new edition of the series Beyond the Tumor: Answering Questions on Ovarian and Breast Cancer, organized by IVOQA and AMOH Association, Dr. Delia Cortés Guiral, surgical oncologist and director of IVOQA, presents the most advanced therapeutic strategies for the treatment of ovarian cancer with peritoneal metastasis. This condition, also known as peritoneal carcinomatosis, represents a clinical challenge that can now be addressed with highly specialized peritoneal oncology techniques.
What is Peritoneal Carcinomatosis in Ovarian Cancer?
Peritoneal carcinomatosis is a form of ovarian cancer spread in which tumor cells implant on the surface of the peritoneum, the membrane lining the abdominal cavity. This condition, once considered inoperable, now has effective therapeutic options thanks to advances in advanced oncologic surgery and localized chemotherapy.
Cytoreductive Surgery: Removing All Visible Tumor
Cytoreductive surgery involves surgically removing all visible tumor implants in the abdominal cavity. It is a complex procedure that requires multidisciplinary expertise and precise surgical planning. This approach is part of advanced oncologic surgery and aims to minimize tumor burden as much as possible, thereby increasing the effectiveness of subsequent treatments.
HIPEC: Hyperthermic Intraperitoneal Chemotherapy
After surgery, HIPEC (Hyperthermic Intraperitoneal Chemotherapy) can be applied. This technique consists of delivering heated chemotherapy directly into the abdominal cavity. The combination of heat and drug enhances the destruction of residual tumor cells, with lower systemic toxicity compared to intravenous chemotherapy.
What Are the Benefits of This Combined Approach?
- Greater local disease control.
- Improved survival in advanced ovarian cancer in selected patients.
- Reduced risk of recurrence.
- Lower systemic impact compared to conventional treatments.
PIPAC: Pressurized IntraPeritoneal Aerosol Chemotherapy
In addition to cytoreductive surgery and HIPEC, Dr. Cortés mentions the use of PIPAC (Pressurized IntraPeritoneal Aerosol Chemotherapy), an innovative technique that allows localized chemotherapy to be administered in aerosol form directly into the peritoneal cavity under controlled pressure. This method improves drug distribution over tumor surfaces and enhances tissue penetration, with very low systemic toxicity.
PIPAC is particularly indicated for patients with advanced or recurrent peritoneal disease who are not candidates for radical surgery and can be used repeatedly as a palliative or disease-control treatment.
The Importance of Referral Centers in Peritoneal Oncology
Dr. Cortés emphasizes that the treatment of ovarian cancer with peritoneal metastasis requires a high level of specialization, surgical expertise, and access to advanced technologies. Therefore, it is essential that patients be evaluated at referral centers in peritoneal oncology, such as IVOQA, where multidisciplinary teams, specific protocols, and active participation in international clinical trials are available.
