Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

HIPEC, or hyperthermic (heated) intraperitoneal chemotherapy is a treatment for some types of cancers that have spread to the lining of the abdominal cavity, such as cancers of the ovaries, appendix, colon, stomach, or abdominal mesothelioma. Unlike normal chemotherapy treatments that are given through an IV and circulated through the bloodstream, this treatment is performed at the time of surgery for cancer and the chemotherapy is heated and placed directly into the abdomen. Once the chemotherapy bathes the lining of the abdomen to come in direct contact with any cancer cells for a period of time, usually between 60-90 minutes, the chemotherapy solution is removed from the abdomen and the procedure is completed.

HIPEC in Ovarian Cancer

Specifically, in ovarian cancer, HIPEC has been used in many different settings: during interval surgery when patients are first diagnosed (neoadjuvant), after completion of chemotherapy when first diagnosed (consolidation), and for recurrence. However, our best data is in the setting after neoadjuvant (chemotherapy before surgery) chemotherapy. In a large Dutch randomized controlled trial in patients with ovarian cancer comparing interval surgery with or without HIPEC, they showed that overall survival could be extended by almost 1 year. This was very impactful as we have had limited studies in ovarian cancer that have been able to move the needle in terms of overall survival, or how long someone lives after being diagnosed with ovarian cancer.

The Dan L Duncan Cancer Center at Baylor St. Luke’s Medical Center is the only hospital in Houston, TX currently offering HIPEC in the treatment of ovarian cancer. Surgery for ovarian cancer is a complex surgery. Adding in HIPEC, makes the surgical procedure even more complex, which is the reason you should be seen by a gynecologic oncologist (a physician who specializes in the treatment of women with gynecologic cancers, such as ovarian cancer) so that they may help decide if you are a candidate. One of the most important factors in how well a patient with ovarian cancer will do is based on their initial surgery and how much of their disease is/was removed at that time.

Patients who undergo an interval debulking and HIPEC could see an improvement in overall survival of one year.

Frequently Asked Questions

Depending on your cancer type, there are different criteria for being a candidate for a HIPEC procedure. In general, if your cancer affects the lining of the abdominal cavity, you may be a candidate for this procedure. Additionally, since a surgery to remove all the tumor that we can see with the naked eye (called a debulking) is performed prior to performing the HIPEC procedure, your surgeon needs to determine if she or he will be able to do this. Only patients where your surgeon believes they could remove all or most of your tumor are candidates for this procedure.

Typically, after surgery + HIPEC treatment, the patient will likely stay in the hospital anywhere from 3-7 days to recover. We will be monitoring vital signs, blood glucose, and especially electrolytes very closely after the procedure. The recovery milestones are no different when comparing HIPEC & surgery to surgery alone.

In general, patients who undergo HIPEC with surgery do just as well as patients who undergo surgery alone. Many of the side effects are similar to those that one could see after surgery and in someone who is receiving normal intravenous chemotherapy: nausea, vomiting, electrolyte abnormalities, brief worsening of kidney function, and possibly a brief stay in the ICU for close monitoring.