Current approaches to the treatment of ovarian cancer with peritoneal dissemination
https://doi.org/10.52888/0514-2515-2025-365-2-117-124
Abstract
The diversity of current treatment methods of ovarian cancer (OC) with peritoneal dissemination, such as cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC), complicates the selection of an optimal strategy and may delay the initiation of treatment. This review systematizes current treatment approaches and presents practical recommendations based on an analysis of recent scientific data. A systemic literature search was conducted in MEDLINE, PubMed, and eLibrary for the period from 2015 to 2025 using the keywords like “ovarian cancer,” “peritoneal dissemination,” “cytoreductive surgery,” “HIPEC,” and “PIPAC.” Studies unrelated to the topic were excluded. The review includes primary studies focused on the treatment of ovarian cancer with peritoneal dissemination.
About the Author
M. M. Hojieva
SI Republican Cancer Research Center, Ministry of Health and Social Protection of Population of the Republic of Tajikistan
Tajikistan
Tajikistan
Hojieva Matluba Muzafarovna - Candidate of Medical Sciences, Deputy Director for Medical Work
Dushanbe
References
1. Khanlarkhani N., Azizi E., Amidi F., Khodarahmian M., Salehi E., Pazhohan A., et al. Metabolic risk factors of ovarian cancer: A review. JBRA Assisted Reprod. 2022;26(2):335–347. https://doi.org/10.5935/1518-0557.20210067.
2. Huang J., Chan W.C., Ngai C.H., Lok V., Zhang L., Lucero-Prisno D.E. III, et al. Worldwide burden, risk factors, and temporal trends of ovarian cancer: A global study. Cancers. 2022;14:2230. https://doi.org/10.3390/cancers14092230.
3. Gaona-Luviano P., Medina-Gaona L.A., Magaña-Pérez K. Epidemiology of ovarian cancer. Chin Clin Oncol. 2020;9(4):47. https://doi.org/10.21037/cco-20-34.
4. Torre L.A., Trabert B., DeSantis C.E., Miller K.D., Samimi G., Runowicz C.D., et al. Ovarian cancer statistics, 2018. CA Cancer J Clin. 2018;68:284–296. https://doi.org/10.3322/caac.21456.
5. Reid B.M., Permuth J.B., Sellers T.A. Epidemiology of ovarian cancer: A review. Cancer Biol Med. 2017;14:9. https://doi.org/10.20892/j.issn.2095-3941.2016.0084.
6. Thomakos N., Diakosavvas M., Machairiotis N., Fasoulakis Z., Zarogoulidis P., Rodolakis A. Rare distant metastatic disease of ovarian and peritoneal carcinomatosis: A review of the literature. Cancers (Basel). 2019;11(8):1044. https://doi.org/10.3390/cancers11081044.
7. van Baal JOAM, van Noorden CJF, Nieuwland R, Van de Vijver KK, Sturk A, van Driel WJ, et al. Development of peritoneal carcinomatosis in epithelial ovarian cancer: A review. J Histochem Cytochem. 2018;66(2):67–83. https://doi.org/10.1369/0022155417742897.
8. Marchetti C., Rosati A., De Felice F., Boccia S.M., Vertechy L., Pavone M., et al. Optimizing the number of cycles of neoadjuvant chemotherapy in advanced epithelial ovarian carcinoma: A propensity-score matching analysis. Gynecol Oncol. 2021;163(1):29–35. https://doi.org/10.1016/j.ygyno.2021.07.025.
9. Ghirardi V., Fagotti A., Scambia G. Laparoscopic selection for surgery in epithelial ovarian cancer: A short review. Facts Views Vis ObGyn. 2023;15(1):25– 28. https://doi.org/10.52054/FVVO.15.1.060.
10. Pujade-Lauraine E., Ledermann J.A., Selle F., Gebski V., Penson R.T., Oza A.M., et al. Olaparib tablets as maintenance therapy in patients with platinumsensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): A double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol. 2017;18(9):1274–1284. https://doi.org/10.1016/S1470-2045(17)30469-2.
11. Du Bois A., Vergote I., Ferron G., Reuss A., Meier W., Greggi S., et al. Randomized controlled phase III study evaluating the impact of secondary cytoreductive surgery in recurrent ovarian cancer: AGO DESKTOP III/ENGOT ov20. J Clin Oncol. 2017;35(15):5501. https://doi.org/10.1200/JCO.2017.35.15_suppl.5501.
12. Di Giorgio A., Abatini C., Attalla El Halabieh M., Vita E., Vizzielli G., Gallotta V., et al. From palliation to cure: PIPAC for peritoneal malignancies. Minerva Med. 2019;110(4):385–398. https://doi.org/10.23736/S0026-4806.19.06081-6.
13. Van Driel W.J., Koole S.N., Sikorska K., Schagen van Leeuwen J.H., Schreuder H.W.R., Hermans R.H.M., et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med. 2018;378(3):230–240. https://doi.org/10.1056/NEJMoa1708618.
14. Saevets V.V., Privalov A.V., Vazhenin A.V., Semenov Yu.A., Schmidt A.V. Treatment of advanced ovarian cancer forms with the use of intraperitoneal chemotherapy combination. Ural Medical Journal. 2021;20(2):28–35. (In Russ.). https://doi.org/10.52420/2071-5943-2021-20-2-XXXXXX.
15. Nazarov Yu., Kopetskiy V., Shudrak Yu. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of primary ovarian cancer stages III– IV. Practical Oncology. 2021;3(2):18–25. (In Russ.). https://doi.org/10.22141/2663-3272.3.2.2020.215660.
16. Zabelin M.V., Safonov A.S., Kuznetsov N.V. Application of cytoreductive surgery technology with HIPEC procedure in the treatment of patients with advanced ovarian cancer. Creative Surgery and Oncology. 2022;12(1):28–34. (In Russ.) https://doi.org/10.24060/2076-3093-2022-12-1-28-34.
17. Ghirardi V., Trozzi R., Scambia G., Fagotti A. Current and future trials about HIPEC in ovarian cancer. Bull Cancer. 2024;111(3):254–260. https://doi.org/10.1016/j.bulcan.2023.01.016.
18. Psomiadou V., Fotiou A., Prodromidou A., Iavazzo C. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in treatment of advanced ovarian cancer: A review of the literature. Eur J Gynaecol Oncol. 2022;43(1):73–77. https://doi.org/10.31083/j.ejgo4301004.
19. Mohammad A., Hor M., Baradeiya A.M., Qasim H., Nasr M. Is pressurized intraperitoneal aerosolized chemotherapy (PIPAC) effective in ovarian cancer with peritoneal metastasis? Cureus. 2022;14(8):e27837. https://doi.org/10.7759/cureus.27837.
20. Taliento C., Restaino S., Scutiero G., Arcieri M., Bernardi G., Martinello R., et al. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with cisplatin and doxorubicin in patients with ovarian cancer: A systematic review. Eur J Surg Oncol. 2023;49(12):107250. https://doi.org/10.1016/j.ejso.2023.03.056.
21. Dzassokhov A.S., Kostin A.A., Astashov V.L., Turiev A.V., Uskov A.D. Prospects of pressurized intraperitoneal aerosol chemotherapy in the treatment of primary ovarian cancer with peritoneal carcinomatosis. Research and Practice in Medicine. 2023;10(1):100– 110. (In Russ.). https://doi.org/10.17709/2410-1893-2023-10-1-9
22. Solass W., Kerb R., Mürdter T., Giger-Pabst U., Strumberg D., Tempfer C., et al. Intraperitoneal chemotherapy of peritoneal carcinomatosis using pressurized aerosol as an alternative to liquid solution: First evidence for efficacy. Ann Surg Oncol. 2014;21(2):553–559. https://doi.org/10.1245/s10434-013-3213-1.
23. Eveno C., Haidara A., Ali I., Pimpie C., Mirshahi M., Pocard M. Experimental pharmacokinetics evaluation of chemotherapy delivery by PIPAC for colon cancer: First evidence for efficacy. Pleura Peritoneum. 2017;2(2):103–110. https://doi.org/10.1515/pp-2017-0015.
24. Tempfer C.B. Pressurized intraperitoneal aerosol chemotherapy as an innovative approach to treat peritoneal carcinomatosis. Med Hypotheses. 2015;85(4):480–484. https://doi.org/10.1016/j.mehy.2015.07.001.
25. Robella M., Vaira M., De Simone M. Safety and feasibility of pressurized intraperitoneal aerosol chemotherapy (PIPAC) associated with systemic chemotherapy: An innovative approach to treat peritoneal carcinomatosis. World J Surg Oncol. 2016;14:128. https://doi.org/10.1186/s12957-016-0892-7.
26. Grass F., Vuagniaux A., Teixeira-Farinha H., Lehmann K., Demartines N., Hübner M. Systematic review of pressurized intraperitoneal aerosol chemotherapy for the treatment of advanced peritoneal carcinomatosis. Br J Surg. 2017;104(6):669–678. https://doi.org/10.1002/bjs.10521.
27. Dzassokhov A.S., Kostin A.A, Astashov V.L., Turiev A.V., Uskov A.D., Andreeva MA. The impact of pressurized intraperitoneal aerosol chemotherapy on surgical treatment outcomes in ovarian cancer with peritoneal carcinomatosis. Research and Practice in Medicine. 2024;11(2):69–80. (In Russ.). https://doi.org/10.17709/2410-1893-2024-11-2-6.
28. Markman M. Intraperitoneal antineoplastic drug delivery: Rationale and results. Lancet Oncol. 2003;4(5):277–283. https://doi.org/10.1016/S1470-2045(03)01074-X.
29. Sgarbura O., Hübner M., Alyami M., Eveno C., Gagnière J., Pache B., et al. Oxaliplatin use in pressurized intraperitoneal aerosol chemotherapy (PIPAC) is safe and effective: A multicenter study. Eur J Surg Oncol. 2019;45(12):2386–2391. https://doi.org/10.1016/j.ejso.2019.08.002.
30. Siebert M., Alyami M., Mercier F., Gallice C., Villeneuve L., Laplace N., et al. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) in association with systemic chemotherapy and bevacizumab: Evaluation of safety and feasibility. Eur J Surg Oncol. 2021;47(1):139–142. https://doi.org/10.1016/j.ejso.2020.09.016.
31. Vizzielli G., Giudice M.T., Nardelli F., Costantini B., Salutari V., Inzani F.S., et al. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) applied to platinumresistant recurrence of ovarian tumor: A singleinstitution experience (ID: PARROT trial). Ann Surg Oncol. 2023;31(2):1207–1216. https://doi.org/10.1245/s10434-023-14648-0.
32. Odendahl K., Solass W., Demtröder C., Giger-Pabst U., Zieren J., Tempfer C., et al. Quality of life of patients with end-stage peritoneal metastasis treated with pressurized intraperitoneal aerosol chemotherapy (PIPAC). Eur J Surg Oncol. 2015;41(10):1379–1385. https://doi.org/10.1016/j.ejso.2015.06.001.
33. Teixeira Farinha H., Grass F., Kefleyesus A., Achtari C., Romain B., Montemurro M., et al. Impact of pressurized intraperitoneal aerosol chemotherapy on quality of life and symptoms in patients with peritoneal carcinomatosis: A retrospective cohort study. Gastroenterol Res Pract. 2017:1–10. https://doi.org/10.1155/2017/4596176.
34. Larbre V., Alyami M., Mercier F., Vantard N., Bonnefoy I., Opsomer M.A., et al. No renal toxicity after repeated treatment with pressurized intraperitoneal aerosol chemotherapy (PIPAC) in patients with unresectable peritoneal metastasis. Anticancer Res. 2018;38(12):6869–6875. https://doi.org/10.21873/anticanres.13062.
35. Ceribelli C., Debs T., Chevallier A., Piche M.A., Bereder J.M. Initial experience of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in a French hyperthermic intraperitoneal chemotherapy (HIPEC) expert center. Surg Endosc. 2020;34(6):2803– 2806. https://doi.org/10.1007/s00464-020-07488-6.
36. Nadiradze G., Giger-Pabst U., Zieren J., Strumberg D., Solass W., Reymond M.A. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) with low-dose cisplatin and doxorubicin in gastric peritoneal metastasis. J Gastrointest Surg. 2016;20(2):367–373. https://doi.org/10.1007/s11605-015-2995-9.
37. Alyami M., Bonnot P.E., Mercier F., Laplace N., Villeneuve L., Passot G., et al. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) for unresectable peritoneal metastasis from gastric cancer. Eur J Surg Oncol. 2021;47(1):123–127. https://doi.org/10.1016/j.ejso.2020.05.021.
38. Al-Batran S.E., Homann N., Pauligk C., Illerhaus G., Martens U.M., Stoehlmacher J., et al. Effect of neoadjuvant chemotherapy followed by surgical resection on survival in patients with limited metastatic gastric or gastroesophageal junction cancer: The AIO- FLOT3 trial. JAMA Oncol. 2017;3(9):1237–1244. https://doi.org/10.1001/jamaoncol.2017.0515.
39. Girshally R., Demtröder C., Albayrak N., Zieren J., Tempfer C., Reymond M.A. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a neoadjuvant therapy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol. 2016;14:253. https://doi.org/10.1186/s12957-016-1008-0.
40. Dzassokhov A.S., Kostin A.A., Astashov V.L., Andreeva M.A., Turiev A.V., Uskov A.D. Dynamic assessment of the impact of pressurized intraperitoneal aerosol chemotherapy on peritoneal carcinomatosis in ovarian cancer: immediate results. Southern Russian Oncology Journal. 2023;4(1):43–51. (In Russ.). https://doi.org/10.37748/2686-9039-2023-4-1-5
41. Giger-Pabst U., Tempfer C.B. How to perform safe and technically optimized pressurized intraperitoneal aerosol chemotherapy (PIPAC): Experience after a consecutive series of 1200 procedures. J Gastrointest Surg. 2018;22(12):2187–2193. https://doi.org/10.1007/s11605-018-3916-5.
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For citations:
Hojieva M.M. Current approaches to the treatment of ovarian cancer with peritoneal dissemination. Health care of Tajikistan. 2025;(2):117-124. (In Russ.) https://doi.org/10.52888/0514-2515-2025-365-2-117-124
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