HIPEC stands for hyperthermic intraperitoneal chemotherapy. It is a cancer treatment approach where heated chemotherapy drugs are delivered directly into the abdominal cavity after cancer surgery.
HIPEC is used to treat cancers that have spread within the peritoneal cavity, which is the lining of the abdomen and pelvis. This includes such as appendiceal tumours and pseudomyxoma peritonei.
Some medical professionals think that HIPEC is a controversial procedure for several reasons.
- Lack of high-level evidence:
Most studies on HIPEC are retrospective case series. Few randomized controlled trials have been done comparing HIPEC to standard treatment. This has led to debates over its actual benefit and criticism that it is mainly performed on highly selected patients.
- Complexity and cost:
HIPEC is a complex, expensive procedure requiring advanced resources and surgical/oncologic expertise. This has limited its widespread adoption and raised questions about whether costs outweigh benefits for certain conditions.
- Morbidity and mortality:
Perioperative morbidity and mortality rates of 3-5% have been reported for HIPEC. Although lower than other major oncologic surgeries, some argue these rates are unacceptable given the unclear benefit.
- Lack of consensus indications:
Although the evidence is clear for pseudomyxoma peritonei, there is no universal agreement on which cancer types and stages can benefit most from HIPEC. Selection criteria vary between treatment centres based on experience and available evidence.
- Pressurized intraperitoneal aerosol chemotherapy (PIPAC):
PIPAC is a newer variant of HIPEC that uses pressurized aerosol chemotherapy instead of heated chemotherapy solution. Small studies suggest PIPAC has lower toxicity and equal-improved efficacy versus HIPEC for some tumours.
HIPEC remains an important option for some patients with advanced cancers, particularly those with peritoneal surface malignancies such as pseudomyxoma peritonei and appendix cancers. Indeed, it is the gold standard of care for these conditions. It is important for patients to discuss the risks and benefits of HIPEC with their medical team to determine whether it is the right option for them.
Adenocarcinoma Ex-Goblet Cell of the appendix is a type of cancer that originates from the cells that line the inside of the appendix.
Pseudomyxoma peritonei (PMP) is a rare and uncommon cancer.
Yes, pseudomyxoma peritonei (PMP) is a rare cancer that usually starts in the appendix and can spread to the peritoneum, which is the lining of the abdominal cavity.
HIPEC in advanced epithelial ovarian cancer:...
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