Hyperthermic intraperitoneal chemotherapy (HIPEC) represents a new treatment 
strategy aimed to improve outcome of patients with advanced ovarian cancer. 
Based on theoretical and experimental basis, HIPEC should stand as an effective 
treatment for ovarian cancer. Literature review reveals a number of different 
experiences on feasibility of this technique, but scientific evidence of current 
studies remains poor. Much more research is still required to elucidate 
unanswered questions. Before this technique can be routinely used, some 
controversial aspects have to be defined: which drug is the best to deliver and 
at what temperature, is it necessary to use mono- or poly-chemotherapy regimens, 
which is the time-point for HIPEC in the natural history of ovarian cancer: at 
front-line therapy, at interval debulking following initial neo-adjuvant 
chemotherapy, at consolidation following front-line therapy, or at the time of 
recurrence. Nevertheless, we must not forget that the most important issue in 
ovarian cancer prognosis is maximal cytoreductive surgery, with no residual 
disease at completion of initial surgery.