AIM: Ovarian cancer may be considered as an "intraperitoneal disease" by itself. 
When surgical removal associated with systemic chemotherapy fails, usually, the 
history of the patients is characterized by poor prognosis. Some encouraging 
results have been reported by the treatment of peritoneal carcinomatosis (PC) 
from ovarian cancer by complete surgical cytoreduction, peritonectomy and 
hyperthermic intraperitoneal chemotherapy (HIPEC). The purpose of this article 
was to evaluate the survival benefit and the morbidity of patients with ovarian 
cancer treated at our institution by cytoreductive surgery associated with 
hyperthermic intraperitoneal perioperative chemotherapy (HIPEC).
METHODS: Between October 1995 and December 2012 more than 600 operations for PC 
were performed; in 308 cases surgical cytoreduction associated with HIPEC was 
carried out. Eighty-five patients treated by cytoreduction associated with HIPEC 
were affected by recurrent epithelial ovarian cancer (EOC). Statistical analysis 
was performed on 70 patients (last 15 patients were too recent for evaluation). 
Two trials were applied: 1) patients presenting first peritoneal relapse after 
surgery and systemic chemotherapy (CT), 6 months later from last CT 
administration; 2) multiple relapse patients.
RESULTS: On 70 patients, morbidity and mortality rates were 35.7% and 7.1%, 
respectively. Overall median survival was 42.0 months, but in primary EOC was 
48.0 months and in recurrent EOC was 28 months (P=0.12). Statistical analysis 
revealed that the completeness of cytoreduction was the most statistically 
significant factor related to survival: in completely citoreduced patients, 
overall survival was 48 months.
CONCLUSION: Citoreductive surgery associated to platinum compounds HIPEC is 
feasible and relatively safe in recurrent and primary PC from ovarian cancer. 
Better selection of patients and second-look surgery in high risk-patients have 
to be investigated to improve those encouraging results.