A team-based approach to care at Mott is essential in the ability to offer the groundbreaking therapy of HIPEC to pediatric patients. Pediatric oncologists, pediatric surgeons, pediatric anesthesiologists, pediatric perfusionists, pharmacists, nursing teams, pediatric critical care specialists, child life specialists, and many others come together to ensure the highest level of care for patients.
The specialized expertise available at Mott, including some of our nations most experienced pediatric surgical oncologists and top-ranked pediatric oncologists, is offered at very few hospitals across the country.
Pediatric surgeons at Mott are well experienced in successfully removing complex abdominal tumors, including the cytoreductive surgeries that are critical to the success of HIPEC.
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HIPEC at C. S. Mott Children’s Hospital, The University of Michigan
What is HIPEC?
HIPEC stands for hyperthermic intraperitoneal chemotherapy (or chemoperfusion). The HIPEC procedure is a type of heated, sterilized chemotherapy solution that is used specifically for patients with complex or advanced peritoneal (abdominal or stomach) cancers that attach to the lining of the abdomen. Hyperthermic refers to heat and intraperitoneal means within – or administered through – the abdominal cavity.
Because the HIPEC procedure is administered directly into the abdomen, it’s not significantly absorbed into the bloodstream, helping minimize side effects associated with traditional chemotherapy.
Types of cancer HIPEC can treat
The most common abdominal cancer in children and in young adults that benefit from HIPEC therapy is a tumor called desmoplastic small round cell tumor, or DSRCT. It is a very rare and aggressive form of cancer typically found in the abdomen. Cytoreductive surgery with HIPEC is an optimal treatment option for DSRCT, with improved disease-free survival and overall survival.
HIPEC is also a good treatment option for the following types of cancers that may affect the abdomen:
- Recurrent disease (disease that comes back) in the abdomen, such as appendiceal cancer and Wilms tumor
- Certain types of sarcomas that have metastasized to the abdominal lining, such as rhabdomyocarcoma
- Malignant ovarian germ cell tumors which can attack the abdominal lining
- Metastatic colorectal cancer
What is HIPEC surgery?
Before HIPEC is administered, cytoreductive surgery is performed. In a cytoreductive surgery, a pediatric surgeon removes any visible tumors throughout the abdomen. Immediately following the cytoreductive surgery, and while still in the OR setting, a specially-trained pediatric surgeon administers the HIPEC treatment. The high-dose, heated chemotherapy administered during the HIPEC procedure can penetrate and destroy the smallest of cancer cells that may be left behind in the abdomen after the tumor removal surgery. In total, the cytoreductive surgery with HIPEC procedure, often takes over eight to twelve hours to complete.
HIPEC for pediatric cancer patients
C.S. Mott Children’s Hospital is one of few medical centers in the United States to offer HIPEC for pediatric patients.
HIPEC is a newer procedure and research has only recently shown that there are long-term survival benefits for pediatric patients.
There are special considerations necessary to successfully administer the HIPEC procedure in pediatric patients, including:
- kidney protection before and during the operation to prevent exposure to the toxicity of chemotherapy – specifically a chemotherapy medication called cisplatin – which can cause kidney failure
- smaller cannula sizes (tubes used to administer medication) for children and young adults
- appropriate dosage and volumes of chemotherapy for children and young adults