HIPEC at University of Wisconsin

What is cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC)?

Hyperthermic intraperitoneal chemotherapy is a form of chemotherapy used after surgeons perform cytoreductive surgery – removal or reduction of any visible tumor during an abdominal operation. Following cytoreductive surgery, heated chemotherapy solution is introduced to the abdomen with the purpose of destroying any cancer cells that may still be present (whether visible or not).

Candidates for HIPEC Treatment

• HIPEC can be used for people with advanced spread of cancer in the abdomen. Specifically HIPEC addresses cancer cells that line the organs within the abdomen, and the actual lining of the abdomen itself.
• At the University of Wisconsin, we treat many different tumor types, which include:

Appendix cancer

Colorectal cancer

Peritoneal mesothelioma

Ovarian cancer

• Furthermore, we have extensive experience with different chemotherapy types, tailored to a patient’s specific tumor. These chemotherapy agents include:

Mitomycin C

Cisplatin

Paclitaxel

Adriamycin

Melphalan

• Patients with fluid re-accumulation in their abdomen (ascites) who may benefit from either traditional or laparoscopic (small incisions) HIPEC.

Advantages of HIPEC

• Surgeons can use higher doses of chemotherapy than traditionally given through the veins.
• Chemotherapy is applied only to the abdomen, reducing the chance of exposure in other parts of the body and potentially minimizing side effects
• Heating the chemotherapy solution in the abdomen (i.e., hyperthermia) has a synergistic effect with the chemotherapy, improving absorption by tumors and susceptibility of cancer cells to chemotherapy. Furthermore, because the chemotherapy is kept within the abdomen, it minimizes the rest of the body’s exposure to the treatment, which helps reduce side effects after surgery
• Even if not all visible tumor is able to be removed, the heated chemotherapy can penetrate small volume disease, allowing organ preservation in accordance with patient wishes.

Why is the University of Wisconsin unique in cytoreductive surgery and HIPEC

• Increasing the sophistication and breadth of our CRS and HIPEC program is a top priority of the Department of Surgery
• We are broadening the scope of our CRS/HIPEC application to include
• minimally invasive approaches (small, laparoscopic incisions rather than large incisions) for appropriately selected patients
• Expansion of CRS and heated chemotherapy in patients with cancer in both their pleural (lung) cavity, as well as any abdominal disease.
• CRS/HIPEC is a major operation that requires the teamwork and experience of all providers, to include surgeons, surgical residents, anesthesiologists, our ICU, nurses, and our nurse practitioners. We are proud of our team, and the excellent care they provide.
• Our CRS/HIPEC surgeons work with Medical Oncologists and Gynecologic Oncologists in a true multi-disciplinary fashion, to decide whether IV chemotherapy is appropriate, and whether IV chemotherapy is best administered before and/or after surgery

Additional Resources