A Cochrane review included 9 studies with a total of 2 119 subjects receiving primary treatment for ovarian cancer. Women were less likely to die if they received an intraperitoneal (IP) component to the chemotherapy (hazard ratio (HR) 0.81; 95% CI 0.72 to 0.90; 8 trials, n=2026) and the disease free interval (HR 0.78; 95% CI: 0.70 to 0.86; 5 trials, n=1311) was also significantly prolonged. There may be greater serious toxicity with regard to gastrointestinal effects, pain and fever but less ototoxicity with the intraperitoneal than the intravenous route.