[Correspondence] Cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy in advanced ovarian cancer – Authors’ reply

Bengü Mutlu Sütcüoğlu and Osman Sütcüoğlu expressed concerns about the lack of stratification based on the completeness of cytoreduction and response to chemotherapy in the OVHIPEC-1 trial.1 While trial designs might indeed benefit from stratification, patients in the OVHIPEC-1 trial were randomly assigned to treatment as soon as the surgical team had deemed whether complete or optimal cytoreduction was feasible. This approach of randomisation before completion of the cytoreductive surgery facilitated timely preparation for the subsequent hyperthermic intraperitoneal chemotherapy (HIPEC) procedure, but precluded stratification based on actual surgical outcome.