Ovarian cancer is one of the most feared gynaecological cancers, often diagnosed at an advanced stage because of the absence of specific symptoms. To improve patient care, new techniques are emerging in gynaecological oncology, notably hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurised intraperitoneal aerosol chemotherapy (PIPAC). These approaches, although recent, offer promising prospects for patients with this disease.
Ovarian cancer is often diagnosed at an advanced stage, which makes it more difficult to treat. Conventional treatments generally combine surgery and intravenous chemotherapy. However, these protocols can prove insufficient for some patients, particularly when peritoneal metastases are extensive.
It is in this context that intraperitoneal chemotherapy techniques, such as HIPEC and PIPAC, play a crucial role.
HIPEC is a technique combining surgery and chemotherapy. It consists of administering a heated chemotherapy treatment directly into the peritoneal cavity after surgery aimed at removing as much visible tumour as possible (cytoreduction).
Key principles of HIPEC:
Indications for HIPEC:
Advantages of HIPEC:
PIPAC is a less invasive technique that consists of administering chemotherapy as an aerosol into the peritoneal cavity. Unlike HIPEC, PIPAC does not require major surgery. It is often used when complete cytoreductive surgery is not possible.
Key principles of PIPAC:
Indications for PIPAC:
Advantages of PIPAC:
The 2 techniques are not competing but complementary. HIPEC is often used after complete cytoreductive surgery, whereas PIPAC is intended for patients for whom major surgery is not an option. The choice of method depends on several factors, such as:
These 2 approaches reflect an important advance in the care of ovarian cancers, making it possible to adapt the treatments to the specific needs of each patient.
HIPEC and PIPAC reflect the progress made in gynaecological oncology. Thanks to these innovative techniques, patients with advanced cancers can benefit from better-targeted and potentially less toxic treatments. However, these procedures must be performed by specialist teams in experienced centres.
These procedures are carried out under general anaesthesia. After the procedure, mild abdominal pain may occur but is generally well controlled with appropriate treatment.
No, a full assessment is necessary to determine each patient's eligibility according to her state of health and the stage of her cancer.
They vary according to the technique, but may include abdominal pain, nausea or fatigue. Systemic side effects are generally less than with conventional chemotherapy.
These techniques are available in centres specialising in oncology and gynaecological surgery, such as university hospitals and certain cancer centres.
No, it is complementary and can be used when conventional treatments are not sufficient or not tolerated.
Medical follow-up after cancer is not limited to watching for recurrences. It supports each patient in managing side effects and gradually returning to normal life, thanks to a multidisciplinary team attentive to your needs.
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