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HIPEC (Hyperthermic Intraperitoneal Chemotherapy) General Information

Posted on: October 16, 2023 *Updated on: May 27, 2024

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a highly specialized surgical technique used in the treatment of advanced abdominal cancers, such as peritoneal mesothelioma, ovarian cancer, and colorectal cancer with peritoneal metastases. This procedure combines surgery with heated chemotherapy delivered directly into the abdominal cavity to target cancer cells that may remain after surgical removal of visible tumors (cytoreductive surgery).

Here are some key points about HIPEC:

Advantages:

  1. Localized Treatment: By delivering the chemotherapy directly into the abdominal cavity, HIPEC aims to provide a higher concentration of the drug to the affected area, thereby increasing its effectiveness.
  2. Reduced Systemic Effects: As the chemotherapy is delivered locally, it reduces the systemic exposure and side effects usually seen with intravenous chemotherapy.
  3. Heat Enhances Effectiveness: The chemotherapy solution is heated to increase its ability to kill cancer cells, and the elevated temperature also enhances the penetration of the chemotherapy into tissues.
  4. Improves Survival Rates: Several studies have indicated that HIPEC can significantly improve survival rates when compared to surgery or systemic chemotherapy alone.

Limitations and Risks:

  1. Surgical Complications: Like any surgical procedure, HIPEC carries risks like infection, bleeding, and complications related to anesthesia.
  2. Chemotherapy Side Effects: Even though the chemotherapy is localized, there can still be systemic absorption, leading to traditional chemotherapy side effects like nausea, hair loss, and low blood counts, although usually to a lesser extent.
  3. Limited Availability: Due to the specialized nature of the procedure, it’s not widely available and is typically performed at academic medical centers with expertise in HIPEC.
  4. Not Suitable for All: Not all patients are candidates for HIPEC. It is generally used for specific types of cancer and is often evaluated on a case-by-case basis.

Procedure:

  1. Cytoreductive Surgery: Surgeons first remove as much of the visible tumor as possible.
  2. Chemotherapy Preparation: A heated chemotherapy solution is prepared, often including drugs like cisplatin, carboplatin, doxorubicin, or mitomycin.
  3. Chemotherapy Infusion: This heated chemotherapy is then circulated in the abdominal cavity for a specified time, usually around 60–90 minutes.
  4. Removal: After the chemotherapy has been circulated, it is removed from the abdominal cavity, and the surgical site is closed.

Because of the complexity and risks associated with HIPEC, it is important for patients to discuss the procedure in depth with their healthcare providers to determine if it is the best treatment option for them.