HIPEC

HIPEC stands for hyperthermic intraperitoneal chemotherapy. It is a cancer treatment that combines cytoreductive surgery to remove visible tumors within the peritoneal cavity with the circulation of heated chemotherapy directly in the abdomen. The aim is to destroy microscopic cancer cells left on peritoneal surfaces while achieving high local drug concentrations and limited systemic exposure.

After debulking, heated chemotherapy solution is circulated in the abdomen for about 60 to 90 minutes at 41 to 43°C. Delivery can be open (coliseum technique) or closed. Agents commonly include mitomycin C or oxaliplatin; choice depends on tumor type and center protocol.

Indications include peritoneal surface malignancies such as pseudomyxoma peritonei, peritoneal metastases from colorectal or gastric cancer, mesothelioma, and select ovarian cancers in carefully chosen patients. Candidacy depends on disease extent, performance status, and absence of unresectable disease.

Evidence from observational studies and some randomized trials suggests improved local control and, in selected diseases, longer survival when HIPEC is combined with cytoreductive surgery, compared with systemic chemotherapy alone. Benefits vary by tumor type and disease extent; significant morbidity remains, and results depend on patient selection and center experience.

Risks and complications include infection, kidney injury, bone marrow suppression, electrolyte disturbances, ileus, and wound problems. The procedure requires multidisciplinary care and an extended recovery period, and HIPEC remains subject to ongoing research and specialization.