Introduction Our objective was to compare the differences between the group of recurrent ovarian cancer patients who underwent secondary cytoreductive surgery with HIPEC and without HIPEC, focused on recurrent pattern after surgery and survival outcomes.

Methods From January 2014 to April 2023 at Ajou university hospital, ovarian cancer patients who underwent secondary cytoreductive surgery were included in this study. Various clinicopathological features, progression free survival and overall survival were evaluated.

Results Total 29 patients (18 patients without HIPEC, 11 with HIPEC during secondary cytoreductive surgery) were identified, and 19 patients experienced recurrence. The groups without HIPEC had a higher incidence of extra-abdominal recurrence compared to the group with HIPEC (63.6% versus 0%, p=0.013). The mean overall survival of patients with extra-abdominal recurrence was 54.9 months, whereas patients without extra-abdominal recurrence was 94.4 months(p=0.028). The median hospitalization duration, estimated blood loss during surgery, complications after surgery (except ileus) has no statistically significant difference between two groups.

Conclusion/Implications Although longer follow-up period and larger population may be necessary, there was higher incidence of extra-abdominal recurrence after secondary cytoreductive surgery without HIPEC than with HIPEC. In the case of recurrent ovarian cancer amenable to surgical intervention, performing HIPEC during cytoreductive surgery may influence the survival rates without significant adverse effect.