History of Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC)


Cytoreductive surgery with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a treatment option for various types of abdominal cancers, including peritoneal mesothelioma. The goal of this procedure is to remove visible tumors (cytoreduction) and treat the area with heated chemotherapy to kill microscopic cancer cells that may remain (HIPEC).

The roots of cytoreduction can be traced back to the work of Dr. Joe Meigs, who first used debulking surgery for ovarian cancer in the 1930s. However, the addition of HIPEC as an adjunct to cytoreductive surgery was largely pioneered by Dr. Paul Sugarbaker of the Washington Cancer Institute. This innovation was significant because it addressed one of the primary challenges of treating abdominal cancers: eradicating microscopic disease that remains after surgery.

Dr. Sugarbaker introduced several advances in the field:

  1. Peritoneal Cancer Index (PCI): A tool for staging peritoneal cancer that helps determine the extent of disease spread and allows for a more tailored treatment approach.
  2. Peritonectomy: The removal of parts of the peritoneal lining, which is often involved in peritoneal cancers. This was integrated into the cytoreduction part of the procedure.
  3. Open Abdominal Technique: This technique allows for better access to the abdominal cavity and more effective distribution of the heated chemotherapy solution.

Due to Dr. Sugarbaker’s substantial contributions, the approach is sometimes referred to as the “Sugarbaker Technique.”

It’s important to note that while Dr. Sugarbaker played a pivotal role in the development of cytoreduction/HIPEC, it was a collaborative effort with input from other researchers, clinicians, and oncologists. Over the years, the technique has been refined and studied further, and it is now considered a valuable treatment option for select patients with abdominal cancers.