Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapy

doi:10.1053/ctrv.2001.0232

Cancer Treatment Reviews

Volume 27, Issue 6, December 2001, Pages 365-374

https://doi.org/10.1053/ctrv.2001.0232 Get rights and content

Abstract

Background: In recent years surgical cytoreduction followed by intra-operative hyperthermic intraperitoneal chemotherapy (HIPEC) was introduced as treatment modality in patients with peritoneal surface malignancy. In the current review the rational for this approach, the prerequisites and the different techniques used are discussed.

Methods: A literature search through PubMed was performed.

Results: Pharmacokinetic studies have shown an important dose advantage for intraperitoneal versus intravenous application. Hyperthermia enhances the penetration of cytostatic drugs into tumour tissue and also shows synergism with various cytostatic drugs. The penetration depth of drugs into tissue is limited, therefore HIPEC can only be effective in patients with minimal residual disease after (aggressive) surgery. HIPEC can be conducted in various ways, without clear proven advantage of one method over the others. Local complications after this combined treatment approach are mainly surgery related. Intraperitoneal chemotherapy may cause systemic toxicity, dependant on the drug used. In randomised studies cytoreductive surgery followed by HIPEC has proven its value in the prevention of peritoneal dissemination in gastric cancer. Phase II data on HIPEC in peritoneal carcinomatosis of colorectal origin and pseudomyxoma peritonei are promising, but randomised studies are still not available.

Conclusion: Aggressive surgical cytoreduction and HIPEC in patients with peritoneal surface malignancy has a clear rational and seems to have clinical value.

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Cytoreductive surgery and intraperitoneal chemotherapy may offer chance for cure for patients with peritoneal metastasis. Many variations emerged, causing uncertainty when choosing the most suitable variant. By reviewing variability encountered in the management of peritoneal metastasis, we aim to raise awareness about this issue and hopefully initiate efforts to solve it.
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^f1: Correspondence to: F.A.N. Zoetmulder MD PhD, Department of General Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam. Tel.: +31/20 512 2550; Fax: +31-20 512 2554; E-mail:[email protected]

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Regular ArticleRationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapy

Abstract

Radiol Clin N America

Eur J Cancer

Eur J Surg Onc

J Surg Res

Eur J Surg Onc

Surgery

Use of nitrogen mustard in treatment of serous effusions of neoplastic origin

JAMA

Pharmacokinetic rationale for peritoneal drug administration in the treatment of ovarian cancer

Cancer Treat Rep

High volume intraperitoneal chemotherapy (“belly bath”) for ovarian cancer. Pharmacologic basis and early results

Cancer Chemother Pharmacol

Long-term survival of advanced refractory ovarian carcinoma patients with small-volume disease treated with intraperitoneal chemotherapy

J Clin Oncol

Intraperitoneal cisplatin plus intravenous cyclophosphamide versus intravenous cisplatin plus intravenous cyclophosphamide for stage III ovarian cancer

N Engl J Med

Intraperitoneal treatment and dose-intense therapy in ovarian cancer

Ann Oncol

Role of cytoreductive surgical treatment in the management of advanced ovarian cancer

Cancer Treat Rep

Secondary cytoreductive surgery for recurrent ovarian cancer. A prospective study

Cancer

Peritonectomy procedures

Ann Surg

Pseudomyxoma peritonei syndrome

Adv Surg

The treatment of malignancy by hyperthermia

Surg Oncol

Status of clinical hyperthermia

Acta Oncol

An update on the anticancer effects of a combination of chemotherapy and hyperthermia

Cancer Res

Hyperthermic peritoneal perfusion system in canines

Cancer Res

Clinical delivery system for intraperitoneal hyperthermic chemotherapy

Cancer Res

Methodologic considerations in treatment using intraperitoneal chemotherapy

Cancer Treat Res

Management of peritoneal-surface malignancy: the surgeon's role

Langenbecks Arch Surg

Continuous hyperthermic peritoneal perfusion for the prevention of peritoneal recurrence of gastric cancer: randomised controlled study

World J Surg

Hyperthermo-chemotherapy combined with cytoreductive surgery for the treatment of gastric cancer with peritoneal dissemination

World J Surg

Thermic homogeneity and standardization of intraperitoneal chemohyperthermia for peritoneal carcinomatosis

Reg Cancer Treat

Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding

Ann Surg

Prophylactic therapy for peritoneal recurrence of gastric cancer by continuous hyperthermic peritoneal perfusion with mitomycin-C

Cancer

Peritoneal expansion by artificially produced ascites during perfusion chemotherapy

Arch Surg

Effects ofintra-abdominal pressure on pharmacokinetics and tissue distribution of doxorubicin after intraperitoneal administration

Anticancer Drugs

Surgically directed chemotherapy: heated intraperitoneal lavage with mitomycin C

Cancer Treat Res

Long term survival of 5 years following initial surgery for gastric cancer and simultaneous disseminated peritoneal metastasis

Surg Today

Does hyperthermia induce peritoneal damage in continuous hyperthermic peritoneal perfusion

World J Surg

Peritoneal-plasma barrier

Cancer Treat Res

The minimal importance of hollow viscera to peritoneal transport during peritoneal dialysis in the rat

Am Soc Artif Intern Organs Transact

Regular Article
Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapy