Hyperthermic intraperitoneal chemotherapy with oxaliplatin as treatment for peritoneal carcinomatosis arising from the appendix and pseudomyxoma peritonei. When heated, this is referred to as hyperthermic intraperitoneal chemotherapy hipec. Hyperthermic intraperitoneal chemotherapy hipec treats advanced stage abdominal cancers, including appendiceal appendix cancer, colorectal cancer, primary peritoneal cancer, peritoneal mesothelioma, ovarian and stomach cancer. Intraperitoneal hyperthermic chemotherapy for abdominopelvic cancers.
Cytoreduction followed by hyperthermic intraperitoneal chemotherapy hipec improves survival in patients with peritoneal carcinomatosis of colorectal origin. Find out information about hyperthermic intraperitoneal chemotherapy. Hyperthermic intraperitoneal chemotherapy article about. Hipec stands for hyperthermic or heated intraoperative peritoneal chemotherapy. Hyperthermic intraperitoneal chemotherapy and cytoreductive. Hyperthermic intraperitoneal chemotherapy early attempts at treatment for peritoneal carcinoma tosis with surgery alone produced rapid rates of pro gression and treatment failure. Intraperitoneal hyperthermic chemotherapy for abdominopelvic cancers page 2 of 8 the difference between traditional intraperitoneal chemotherapy and iphc is that in the traditional form, the chemolytic agents may be infused at the time of surgery or over a course of several days, however, these agents are not heated before being infused. The majority of patients with ovarian cancer oc receive an initial diagnosis of advanced disease that has spread from the ovaries to the peritoneal surface. Hyperthermic intraperitoneal chemotherapy in ovarian. Many different drug combinations and hipec regimens including bidirectional, i. Hyperthermic intraoperative peritoneal chemotherapy hipec is also done for other cancers that have spread to the peritoneal surfaces of the abdomen after cytoreduction debulking surgery is completed, such as ovarian, colon, gastric and pancreatic cancers. This is referred to as early postoperative intraperitoneal chemotherapy epic. Hyperthermic intraperitoneal chemotherapy hipec is considered medically necessary when used in. Hyperthermic intraperitoneal chemotherapy in ovarian cancer article pdf available in new england journal of medicine 3783.
Intraperitoneal delivery exposes the tumor to concentrations of cytotoxic drugs much greater than with intravenous delivery, and in vitro studies have also shown that combining hyperthermia and platinum leads to an additive cytotoxic effect. Intraoperative hyperthermic intraperitoneal chemotherapy. Hyperthermic intraperitoneal chemotherapy with paclitaxel. This may be complemented in some instances with early postoperative intraperitoneal chemotherapy epic. We included comparative studies, and found that the overall survival os and progressionfree survival pfs in hipec groups were superior to groups without hipec treatment in the all total population hr. Candidates for hyperthermic intraperitoneal chemotherapy our doctors may recommend hipec as a treatment for people with cancer that is confined to the abdominal cavity. The application principles of hipec for use in peritoneal disease were also summarized. Hyperthermic intraperitoneal chemotherapy hipec, also called heated chemotherapy, may be an option for people with latestage cancer of the appendix or colon, or in some cases, ovarian or uterine cancer that has spread. The rationale of hipec is based on the direct cytotoxicity of hyperthermia for malignant cells, the enhancement of this cytotoxicity by anticancer drugs, and the pharmacokinetic advantages of the. Page 3 of 8 emerging literature from case series and retrospective studies has demonstrated that intraoperative hipec can be of benefit to patients with isolated peritoneal carcinomatosis no extraabdominal metastases from colorectal cancer. Its time to warm up to hyperthermic intraperitoneal.
Hipec is a system in which heated chemotherapy is delivered directly inside the abdomen during surgery. Intraperitoneal instillation of the chemotherapeutic agent allows for a much higher chemotherapeutic dose than could be tolerated systemically. Hyperthermic intraperitoneal chemotherapy, or hipec, is a heated chemotherapy that is administered after cytoreductive cancer tumorremoving surgery to treat cancers that spread to the lining of the abdomen. Study of hyperthermic intraperitoneal chemoperfusion. Available data investigating the outcomes of hipec are mostly limited to singlecenter studies. This innovative, aggressive treatment targets and destroys microscopic cancer cells that cannot be seen by the human eye. The effectiveness of hipec is based on the achievement of a hyperthermic intracavity.
It is a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery. Hyperthermic intraperitoneal chemotherapy program nyu. November 20, 2019 prior authorization required if required, submit supporting clinical documentation pertinent to service request. Hyperthermic intraperitoneal chemotherapy hipec main. This allows the powerful drugs to destroy any cancerous cells. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal goblet cell carcinomas with peritoneal carcinomatosis. Hyperthermic intraperitoneal chemotherapy hipec and early postoperative intraperitoneal chemotherapy epic are two treatment methods that serve this role and have been shown to improve survival. Pdf the combination of complete cytoreductive surgery and perioperative intraperitoneal chemotherapy provides the only chance for longterm survival. Previous studies about the prognostic value of the hipec have yielded controversial results. Hyperthermic intraperitoneal chemotherapy hipec delivered in the operating room once the cytoreductive surgical procedure is finalized, constitutes the most common form of administration of perioperative intraperitoneal chemotherapy. Hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis 6 7. Hyperthermic intraperitoneal chemoterapy hipec and.
At the end of the surgery to remove the tumor, the patients abdominal cavity is bathed in a heated, highly concentrated chemotherapy solution to eliminate any residual cancer. Also known as hot chemotherapy, hipec is performed after the surgeon removes tumors or lesions from the abdominal area. Hyperthermic intraperitoneal chemotherapy hipec is a treatment used immediately following cytoreductive surgery for treating some cancers that have spread into the peritoneal cavity. When hyperthermic intraperitoneal chemotherapy is administered, doctors pump a mixture of chemotherapy drugs and heated saline solution directly into a mesothelioma patients abdomen.
Importance hyperthermic intraperitoneal chemotherapy hipec and cytoreductive surgery have been shown to benefit selected patients with peritoneal carcinomatosis. We conducted a trial to investigate whether the addition of hyperthermic intraperitoneal chemotherapy hipec to interval cytoreductive surgery would improve outcomes among patients who were. Exposure of the surgical team to toxic drugs during hyperthermic intraperitoneal chemotherapy hipec remains a matter of great concern. Intraoperative hyperthermic intraperitoneal chemotherapy hipec page 3 of unitedhealthcare oxford clinical policy effective 08012017 19962017, oxford health plans, llc intraperitoneal. Animal models are important in the evaluation of new treatment modalities. Oxaliplatinbased versus irinotecanbased hyperthermic.
Chemotherapy can be administered orally, systemically i. However, these procedures are associated with high morbidity and mortality. Optimal cytoreduction is generally considered the removal of all tumors greater than 1 cm for ovarian cancer whitney and spirtos, 2009 and greater than 2. Hyperthermic intraperitoneal chemotherapy hipec is a treatment used.
Surgical cytoreduction resection of visible disease in conjunction with hyperthermic intraperitoneal chemotherapy hipec is designed to remove visible tumor deposits and residual microscopic disease. Hyperthermic intraperitoneal chemotherapy hipec in ovarian cancer. Hyperthermic intraperitoneal chemotherapy definition of. Hyperthermic intraperitoneal chemotherapy hipec gateshead. Hyperthermic intraperitoneal chemotherapy hipec the christie. Cytoreductive surgery crs combined with hyperthermic intraperitoneal chemotherapy hipec is an accepted treatment for peritoneal metastases pm of appendiceal and. Intraoperative hyperthermic intraperitoneal chemotherapy hipec. Tissue that lines the abdomen and organs in the abdomen.
Hyperthermic intraperitoneal chemotherapy hipec max. What made hyperthermic intraperitoneal chemotherapy an effective curative treatment for peritoneal surface malignancy. Marcotte e, dube p, drolet p, mitchell a, frenette s, leblanc g, et al. How is hipec hyperthermic intraperitoneal chemotherapy.
Cancer that has spread to other parts of the body, such as the brain or lungs, cannot be treated with hipec. Hipec is an innovative approach to administering chemotherapy directly to the abdominal cavity and thus to cancerous tumors. Therefore, this study aims to assess the impact of hipec on patients with ovarian cancer. Hyperthermic intraperitoneal chemotherapy for select intra. Intraoperative hyperthermic intraperitoneal chemotherapy hipec page 1 of 14 unitedhealthcare commercial medical policy effective 06012019 proprietary information of unitedhealthcare. Hipec is hyperthermic intraperitoneal chemotherapy, an innovative method designed to effectively treat primary and metastatic cancers in the abdomen. Hyperthermic intraperitoneal chemotherapy hipec effective. Gynecologic oncology group surgical procedures manual. Intraoperative means the chemotherapy solution is circulated into the abdomen peritoneal cavity while the patient is still in surgery at the time of the cytoreduction.
Standard chemotherapy drugs are administered directly into a patients bloodstream. In an attempt to improve the effectiveness of chemotherapy, an intraperitoneal hyperthermic approach has been proposed for the treatment of pc. The prognosis impact of hyperthermic intraperitoneal. Following surgery to remove as much of the tumor as possible, a solution of heated chemotherapy drugs is pumped into the abdomen to target any cancer cells. Cytoreductive surgery crs and hyperthermic intraperitoneal chemotherapy hipec provide an effective treatment option for selected patients with colorectal peritoneal metastasis with encouraging survival results.
The role of intraperitoneal chemotherapy is to maximize tumor penetration and optimize cell death while minimizing systemic toxicity. What made hyperthermic intraperitoneal chemotherapy an. The most effective treatment for patients with advanced disease is cytoreductive surgery followed by systemic chemotherapy. Pdf hyperthermic intraperitoneal chemotherapy hipec in. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. The purpose of this study was to devise an experimental setting which can be routinely used for the investigation of hipec in peritoneal carcinomatosis. Hipec is an alternative and innovative method of delivering chemotherapy, which. Hyperthermic intraperitoneal chemotherapy hipec is a locoregional treatment that involves the washing of the peritoneal cavity with a heated solution and high drug concentrations. Closed hyperthermic intraperitoneal chemotherapy with open. Indications for hyperthermic intraperitoneal chemotherapy. The extensive surgical resection and hyperthermic chemotherapy, however, have systemic effects requiring careful anesthetic management.
Hyperthermic intraperitoneal chemotherapy hipec added 06 march 20. Hyperthermic intraperitoneal chemotherapy hipec and early postoperative intraperitoneal chemotherapy epic are two treatment methods that serve this role. The peritoneal spread of ovarian cancer makes it a potential target for hyperthermic intraperitoneal chemotherapy hipec. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy has been the only therapy to consistently achieve significant 5year survival rates in patients with peritoneal metastasis who have tumors arising from the appendix, colon, rectum, mesothelium, and ovary. Hyperthermic intraperitoneal chemotherapy hipec in newly diagnosed advanced ovarian cancer. Hipec cooperative program md anderson cancer center.
Hipec chemotherapy for cancer that has spread to and diffusely covers the internal organs within the peritoneum. Pdf hyperthermic intraperitoneal chemotherapy in ovarian. Hyperthermic intraperitoneal chemotherapy hipec in newly. Cytoreductive surgery and hipec in recurrent epithelial ovarian cancer. Outcomes of cytoreductive surgery with hyperthermic.
Hyperthermic intraperitoneal chemotherapy hipec, also referred to as intraperitoneal hyperthermic chemotherapy iphc, has been proposed as an alternative for the treatment of cancers within the peritoneal cavity, including primary peritoneal mesothelioma and gastric cancer. During closedabdomen hipec, operating room staff are not exposed to drugs, but the distribution of the heated liquid within the abdomen is not optimal. Find support for a specific problem on the support section of our website. Hyperthermic intraperitoneal chemotherapy hipec is a cancer treatment that involves filling the abdominal cavity with chemotherapy drugs that have been heated.