Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is a surgical approach that can be used to treat tumors that have spread inside the abdominal cavity – known as peritoneal disease. The combination of surgery and regional chemotherapy has advantages for treating certain types of cancers. Unlike standard chemotherapy, which is given intravenously according to a predetermined schedule of alternating treatments and rest periods, HIPEC is administered in a single session that takes place immediately during the surgical procedure after the tumors are removed. This allows for a higher concentration of the drug to reach the tumor.
How does HIPEC work?
After all visible tumors are surgically removed, a highly concentrated, heated chemotherapy solution is pumped directly into the stomach cavity, where it circulates and targets any remaining cancer cells. HIPEC works for approximately 90 minutes while the patient lies on a special cooling pad. Afterward, the 108-degree chemo bath is washed away, the surgical incisions are closed, and the patient begins the recovery process.
"The treatment of patients with peritoneal disease involves complex decision making. We think all such patients should be evaluated at a specialized center with a dedicated team to help patients achieve the best results."- Dr. Sean Dineen
Who is a candidate for CRS/HIPEC?
CRS/HIPEC is a procedure that may benefit patients with peritoneal spread of their cancer. Candidates for the surgery should have a good medical history since the surgery is invasive. HIPEC can be the primary approach for therapy or can be used in conjunction with other treatments.
HIPEC is most commonly used to treat patients with the following cancers:
HIPEC can also be effective when used as supportive therapy for patients who have a malignant ascites (an accumulation of fluid in the stomach cavity), which is a common side effect of peritoneal tumors.
Benefits of HIPEC
As compared to traditional chemotherapy, HIPEC has several advantages, including:
- Fewer side effects – Rather than entering the bloodstream and circulating throughout the entire body, the cancer-fighting medication is delivered directly into the stomach cavity, increasing the concentration of drug where the cancer was located. As a result, the chemo is less likely to be absorbed and affect healthy tissues and organs.
- Greater effectiveness – The heated chemotherapy solution causes blood vessels in the peritoneum to expand, allowing the medication to penetrate more deeply for better absorption. Also, because the chemo drugs are concentrated in the peritoneal cavity, a higher dose can be administered without causing adverse effects.
- A single treatment – Unlike standard chemo, which is delivered intravenously in multiple sessions over several weeks or months, HIPEC is one treatment given in the operating room after cytoreductive surgery.
For some patients, especially those who have an aggressive or difficult-to-treat type of cancer, HIPEC may lead to a better outcome and enhanced quality of life.
CRS/HIPEC at Moffitt
At Moffitt Cancer Center, a multispecialty team assesses each patient’s needs to determine the best strategy for treating peritoneal metastasis. Because we believe that informed patients make better treatment decisions, we fully educate each patient about the role of surgery, chemotherapy and radiation, including their purposes and potential side effects as well as any possible alternatives.
Moffitt’s renowned research team is continually investigating the effectiveness of new treatments. Through our robust clinical trials program, our patients have opportunities to benefit from promising new surgeries, drug combinations and chemotherapy delivery methods before those options are available in other settings. This is just one way that Moffitt is consistently challenging the odds by improving both patient outcomes and quality of life.
Medically Reviewed by Dr. Sean Dineen, Gastrointestinal Oncology Program
If you’d like to learn more about hyperthermic intraperitoneal chemotherapy, you are encouraged to talk with a member of the Gastrointestinal Oncology Program at Moffitt Cancer Center. To request an appointment, call 1-888-663-3488 or complete our new patient registration form online.