HIPEC or hyperthermic intraperitoneal chemotherapy is an innovatory system applied to treat cancers that have originated in or spread to the abdominal cavity, such as appendiceal cancer, pseudomyxoma peritonei, colon cancer, gastric cancer, ovarian cancer, and peritoneal mesothelioma.
The treatment has two primary elements
- Surgical cytoreduction
- Surgical cytoreduction:
This requires removal of the tumor within the peritoneal cavity to no visible residual disease or residual disease less than or equal to 2.5mm. This is termed as complete or near-complete cytoreduction. To achieve this state of complete cytoreduction, multiple extensive surgical resections might need to be performed, such as peritonectomy, multiple bowel, and visceral resections.
Only after achieving a complete or near-complete cytoreduction can HIPEC be administered. If gross residual disease is left behind HIPEC is not justified. During HIPEC, a special machine heats the fluid and the chemotherapeutic agent to a temperature of 42-44 degrees which is then pumped into the abdominal cavity@of 1ltr/min. Around 4-6 liters of fluid is circulated within the abdominal cavity throughout 60mins, through intrabdominal placed drains.