Peritoneal carcinomatosis from advanced ovarian cancer:To treat or not to treat ethical issues suggested by a case study

This article provides a brief description of an Epithelial Ovarian Cancer (EOC) case (stage IV) treated with the association of complete CytoReductive Surgery and Hypertermic IntraPEritoneal Chemotherapy (HIPEC). The use of HIPEC in EOC makes theoretic sense in view of the high rates of recurrence following standard treatment, but there are no randomized clinical trial to date and HIPEC for these patients still represents a radical treatment where the choice of no treatment may be acceptable since definitive cure is unlikely. We reviewed the entire decision making process considering the risk/benefit of the procedure in term of mortality/morbidity, the quality of life and the psychological profile of the patient 1 year after surgery. The platform World Health Organization- International Classification of Functioning, Disability and Health that permits evaluation of the person in relation to the psycho-social context is presented. A person-centred approach and assessment of health-related quality-of-life and disability in EOC survivors are of central importance for decision making.