Roswell Park

Elm & Carlton St.
Buffalo, NY 14263

Dr. John Kane

Chief of Surgical Oncology

HIPEC at Roswell Park

CS/HIPEC for Advanced Abdominal Disease

Peritoneal carcinomatosis (PC) affects approximately 10% to 30% of patients with colorectal cancer and represents a challenging treatment issue for these patients. Response to modern oxaliplatin- and ironotecan-based systemic chemotherapy remains disappointing and median overall survival for colorectal PC is 12.7 months with a 5-year overall survival of ≤ 4% (Franko, et al. JCO 2011).

A complex procedure, CS/HIPEC can be done safely and offers many patients an effective therapeutic option.

HOW CS/HIPEC WORKS

After meticulous cytoreductive surgery to debulk the tumor(s), the peritoneal cavity is bathed with heated, high-dose chemotherapy. The procedure entails:

  • Removal of gross tumor through a combination of visceral resection and selective peritonectomies only for involved surfaces (no “peritoneal stripping”)
  • Chemotherapy dosing at 3 to 4 times the maximum tolerated dose for systemic therapy (taking advantage of the plasma/peritoneal barrier)
  • Mitotycin C is used most commonly
  • Hyperthermia—42˚C for 90 minutes—increases drug uptake by tumor cells and may be directly tumoricidal
  • At procedure’s end, all chemotherapy is removed Duration of hospital stay averages 10 to 14 days

BENEFITS OF CS/HIPEC

  1. Direct access to the tumor
  2. Minimizes tumor burden
  3. Maximizes chemotherapy dose (taking advantage of the plasma/peritoneal barrier)
  4. Achieves true fever range hyperthermia to increase response rates
  5. Does not preclude other therapies such as systemic chemotherapy

As a multidisciplinary comprehensive cancer center, we call upon highly-skilled professionals from all areas of cancer care, dedicated to treating the whole patient, not just their cancer. We work as a team along with the patient’s primary physician or community-based oncologist to provide optimal care delivered with compassion and respect.