Cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is an advanced and extensive surgical procedure combined with a one-time treatment with heated chemotherapy at the end of the operation. Only a very selected group of patients suffering from peritoneal carcinomatosis (cancer spread within the abdominal surface) can undergo this procedure. These typically include some patients with appendiceal cancer, pseudomyxoma peritonei, ovarian cancer, mesothelioma, and colorectal cancer. The procedure is performed in a few hospitals in the USA only. A patient support website is available.
HIPEC treatment is not widely accepted by the US physician community despite a very good evidence from a prospective randomized trial (Verwaal 2003), and other studies (Elias 2009, Franko 2008, Glehen 2004). This approach is considered a gold standard in certain European countries, e.g. in France (Elias 2010). Nevertheless, given very poor prognosis of peritoneal carcinomatosis, it is currently considered the best treatment option available and is endorsed by a number of leading American surgical oncologists (Esquivel 2007).
The first HIPEC treatment in the Mercy Medical Center was in December 2008. At the time of this writing the Mercy Medical Center is the only Iowa center offering this therapy. Watch a news report and learn more on the KCCI website.
Resources on HIPEC from Mercy Surgical Oncologists
Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion versus systemic chemotherapy alone for colorectal peritoneal carcinomatosis. (in press) Franko J, Ibrahim Z, Gusani NJ, Holtzman MP, Bartlett DL, Zeh HJ: Cancer 2010. In press.
Multivisceral resection does not affect morbidity and survival after cytoreductive surgery and chemoperfusion for carcinomatosis from colorectal cancer. Franko J, Gusani NJ, Holtzman MP, Ahrendt SA, Jones HL, Zeh HJ 3rd, Bartlett DL. Ann Surg Oncol. 2008 Nov;15(11):3065-72. Epub 2008 Aug 19
Aggressive surgical management of peritoneal carcinomatosis with low mortality in a high-volume tertiary cancer center. Gusani NJ, Cho SW, Colovos C, Seo S, Franko J, Richard SD, Edwards RP, Brown CK, Holtzman MP, Zeh HJ, Bartlett DL. Ann Surg Oncol. 2008 Mar;15(3):754-63
Case-matched comparison of survival after cytoreductive surgery and intraperitoneal hyperthermic chemoperfusion for peritoneal carcinomatosis versus liver resection for metastatic colorectal cancer. Franko J, Gusani NJ, Holtzman MP, Ahrendt SA, Zeh HJ, Bartlett DL: 2008 ASCO Annual Meeting. May 30 - June 3, 2008 in Chicago, Illinois. Abstract ID: 4058.