HIPEC

HIPEC (Hhyperthermic IntraPEritoneal Chemotherapy)

 

What is HIPEC?

 

HIPEC is a combination of surgery and intra-operative chemotherapy to treat cancer with local spread confined to the abdomen.

Many intra-abdominal tumors may spread to the peritoneum (which is a lining covering most intra-abdominal organs and the inside portion of the abdominal wall). When the tumor involves the peritoneum we use the term “peritoneal carcinomatosis”.

Historically, the survival of patients with peritoneal carcinomatosis is only several months.

 

How Does it Work?

 

The tumor is surgically removed from the abdomen.

 

Chemotherapy is then delivered inside the abdomen at the time of surgery. The solution containing the chemotherapy drug is heated to a temperature between 104 and 107 Fahrenheit (40-42 Celsius) and circulated in the abdomen for 120 minutes. An external pump with a heat exchanger is used to re-circulate the fluid and keep its temperature in the desired range.

 

How is the procedure performed?

 

This procedure is performed in the operating room under general anesthesia.

 

The first step of the procedure is “cytoreduction” At the time of surgery the abdomen is opened and tumor removed. Several organs may need to be removed if involved by the tumor. The purpose of cytoreduction is to remove all visible disease with human eye. The length of this surgery may require several hours.

 

The second step of the procedure is the administration of intra-abdominal chemotherapy. The drug is delivered in the abdomen via two tubes placed in the upper abdomen (inflow cannulas). After the solution enters the abdomen it will spread everywhere and will exit via two exit tubes located in the lower abdomen (outflow cannulas). The abdomen is constantly shaked by the surgeon. The length of this chemotherapy treatment is about 120 minutes.

 

At the end of this treatment the abdomen is closed and the patient is transferred to the intensive care unit for postoperative management. The average length of this procedure is 9 hours. The average hospital staying with no complications is about 10 days.

 


 

What are the Key Benfits?

 

If the tumor is completely resected the administration of intraperitoneal chemotherapy is associated to an outcome that is remarkably better than standard systemic therapy.

 

Other factors associated to a good outcome are type of tumor, preoperative performance status, and uncomplicated postoperative course.

 

The intraperitoneal administration of chemotherapy allows a drug concentration in the abdomen that is 20-600 times higher compared with intravenous drug administration. The absorption of the drug in the rest of the body is minimal.

 

The addition of heat improves drug penetration into the tumor.

 

Depending on the biology of the tumor, recurrent disease is definitely a possibility. HIPEC can be repeated with the same benefit.

 

Complete cytoreductive surgery and addition of chemotherapy are associated to remarkable outcomes.

 

 

What are the most common tumors that may benefit from HIPEC?

 

Tumor of the appendix

Mucinous intra-abdominal tumors

Recurrent Colon cancer tumors

Peritoneal tumor (mesothelioma)

Other tumors may require more selection

 

Which patients may benefit from HIPEC?

 

In order to minimize complications and optimize the outcome, patients are strictly selected.

Patient need to have a good performance status which means fully active and physically limited only for strenuous activity.

Patient should not have extra-abdominal disease or extensive liver involvement by tumor.

Patient should not have any severe concomitant disease from cardiac or pulmonary standpoint.

 

What are the Risks of HIPEC?

HIPEC is an invasive procedure that carries its risks. The risk of dying from this procedure is about 4-5%. The risks of any postoperative complications range between 23 and 43%. Complications may prolong hospital staying and if severe may be detrimental in terms of outcome.

The recovery time from this procedure varies from 3 to 12 months.


First Surgical Office Locations

Oakland Office
365 Hawthorne Ave, #101
Oakland, Ca 94609
Ph# 510-465-5523
Fax# 510-832-6061

Berkeley Office
2999 Regent St #700
Berkeley, Ca 94705
Ph# 510-486-0818
Fax# 510-486-0819

Hayward Office
27001 Calaroga Ave, #4
Hayward, Ca 94544
Ph# 510-732-5731
Fax# 510-732-5739

Chinatown Office
388 9th St #218B
Oakland, Ca 94607
Ph# 510-839-0298 
Fax# 510-839-4389

Bariatrics Office (Summit South)
3100 Summit St, #2600
Oakland, Ca 94609
Ph# 510-869-8972
Fax# 510-869-6989


Comprehensive Cancer Center
2001 Dwight Way
Berkeley, CA 94704
Ph# 510-204-1634
Fax# 510-204-5749