HIPEC Procedure and Description
HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a procedure used in cancers that have spread to the surface of the peritoneal cavity. A heated and sterile solution with added chemotherapy medication (up to 42ºC) is circulated in the abdomen for approximately 90 minutes with the goal of destruction of any hidden tumor cells. It is applied directly following peritonectomy and/or Cytoreductive Surgery (CRS).
HIPEC treatment provides surgeons with the ability to apply high doses of chemotherapy directly into the peritoneal cavity without significant toxicity to the remainder of the body. The effects of the heat may increase the efficacy of the treatment. In this way, the normal side- effects of chemotherapy can be avoided.
HIPEC treatment is used in Peritoneal Carcinomatosis. This is a broad description of a variety of tumors that present with extensive metastasis throughout the peritoneal cavity in tissues such as the appendix, colon, gallbladder, ovaries, mesothelioma, pancreas, stomach and pseudomyxoma peritonei.
Basic principles of the HIPEC procedure is built on the following scientific foundations:
- An elevated body temperature, or fever (between 37.5º and 41ºC) does have a beneficial effect on the outcome of infections.
- At temperatures between those of natural fevers and the beginning of tissue destruction (between 41º and 45ºC) heat may have a natural therapeutic role because pathogens are more thermosensitive than normal tissue.
- Living tissue is susceptible to destruction by heat (generally >45ºC).
- Hyperthermia damages the membranes, cytoskeleton and nucleus functions of malignant cells.
- Hyperthermia causes irreversible damage to cellular perspiration of these cells. Heat at 42ºC also pushes cancer cells towards acidosis, which decreases the cells’ viability and transplantability.
- Heat is known to stimulate the immune system causing both increased production of interferon alpha and increased immune surveillance.