HIPEC and Other Treatments for Peritoneal Surface Malignancies

Peritoneal surface malignancies are rare but serious cancers that develop on the lining of the abdomen, called the peritoneum. They often develop when tumors from the appendix, rectum, colon, stomach, ovaries or other organs spread to peritoneal surfaces.

UC San Diego Health's surgical oncology team is one of the most experienced in the world in treatments for these advanced abdominal cancers, including cytoreductive surgery followed by heated intraperitoneal chemoperfusion (HIPEC).

However, not every patient is a candidate for surgery with HIPEC. If this is not the right treatment for you, our team may recommend:

  • Immunotherapy, the use of drugs to stimulate the immune system to fight cancer
  • Personalized cancer therapy, treatments tailored to abnormal genes in your particular tumor. These may include "experimental therapeutics," or new medications that are only available through clinical trials at an academic health system like UC San Diego Health. 
  • Rare tumors clinic, a Moores Cancer Center team that specializes in rare cancers.

Understanding HIPEC

You may have heard of HIPEC under another name: IPHC, chemo-bath, HIIC (heated intraoperative intraperitoneal chemotherapy), intraperitoneal chemohyperthermia, or continuous hyperthermic peritoneal perfusion.

HIPEC, a form of chemotherapy during surgery, is performed at the end of surgery to remove abdominal tumors. Once all visible tumors have been removed (called “cytoreduction”), the surgeon continuously circulates a heated, sterile chemotherapy solution throughout the peritoneal cavity for up to 90 minutes. The HIPEC procedure is designed to attempt to kill any remaining cancer cells that cannot be seen. The solution is then removed and the incision closed.

Giving the chemotherapy in the abdomen at the time of surgery allows for greater concentrations of the drug where it is needed. Adding heat has a threefold advantage:

  • Heat above 41 degrees Celsius more effectively kills cancer cells while having fewer effects on normal cells.
  • Heat allows the chemotherapy to penetrate a few millimeters and kill cancer cells that cannot be seen.
  • The chemotherapy dose can be higher than that given intravenously because it is not absorbed by the body in the same way. In this way, the normal side effects of chemotherapy can be avoided.

There is substantial clinical evidence that HIPEC is an effective treatment for patients with pseudomyxoma peritonei, mucinous adenocarcinoma of the appendix, and peritoneal mesothelioma. Additionally, peritoneal metastases from colon cancer can be successfully treated in a significant number of patients. For more information, see Cancers That Can Be Treated with HIPEC.

Leaders in the Field

The UC San Diego Health team is one of the most experienced in the world at this procedure. Our four surgeons are experts in complex abdominal surgery for peritoneal metastates. They have performed hundreds of cytoreductive/HIPEC surgeries, and typically perform 2–3 procedures a week. We have a highly experienced staff as well, including seasoned nurses, medical oncologists, and others familiar with the needs of patients undergoing cytoreductive surgery and HIPEC. For more information, see our physician bios below or HIPEC Outcome Data.

HIPEC in the News

Our experts have been profiled by CBS Evening News, The New York Times, and numerous other media outlets. Find news stories on HIPEC, along with articles published in medical journals about the procedure, in Resources for HIPEC Patients.

 

Clinical trial: Minimally invasive HIPEC

Patients with minimal or early-stage disease may be candidates for a clinical trial exploring the possibility of minimally invasive surgery, which uses smaller incisions and can result in a shorter recovery period. In this video, Dr. Kelly discusses how UC San Diego Health developed minimally invasive techniques for several complex cancer surgeries, including cytoreduction with HIPEC, during this clinical trial's developmental phase. The trial is now in an expansion phase and is still open for patients who fit the criteria.

Surgical oncologist Joel Baumgartner, MD, a member of Moores Cancer Center's HIPEC team, describes the procedure.

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