Introduction/Background Ovarian cancer (OC) is the eighth leading cause of cancer in women worldwide, with high mortality due to the advanced stage at which it is diagnosed. Neoadjuvant chemotherapy is a treatment option in patients who are not candidates for primary surgery. HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a treatment option during interval laparotomy. Our objective is to present the patterns of recurrence between patients treated with chemotherapy and interval surgery and those who underwent HIPEC, within an institutional protocol.

Methodology The review of 33 patients who were treated between 2016–2022 was carried out, 17 of them underwent HIPEC during interval laparotomy. Demographic variables and sites of recurrence, as well as disease status, were analyzed.

Results During a median follow-up of 36 months, from 16 cases in the non-HIPEC group, there were 8 recurrences (50%): 2 systemic (lung, liver), 1 in the groin, 2 in the perigastric nodes, 1 peritoneal, and 1 in the gastric wall; while in the HIPEC group, 6 patients (35.3%) recurred: 3 systemic, 1 in a pelvic node and 2 in peritoneum. In the non-HIPEC group, there were 6 (37.5%) deaths, 4 (25%) patients are alive with disease, and 6 alive without evidence of disease. In the HIPEC group, 5 (29.4%) patients died, 3 (17.6%) are alive with disease, and 9 (52.9%) are alive without disease.

Conclusion Various patterns of recurrence have been reported in patients after interval surgery, being the peritoneum and abdominopelvic lymph nodes the most frequent sites; and post-HIPEC recurrence are most common in visceral tissues. In our series, the recurrences are highly variable in the non-HIPEC group, with systemic disease being the most common; in the HIPEC group, systemic recurrences are more alike with usual patterns in OC, however, the peritoneum continues to be a point of relapse despite the HIPEC.