Hyperthermic intraperitoneal chemotherapy (HIPEC), a new treatment for advance cancer stages conceived about 30 years ago, is a global game-changer in impro
ving survival rates, however, not many patients in Greece and other European countries are getting this treatment due to a lack of awareness in the medical community.
Understanding HIPEC and its application
HIPEC is a new procedure that only became available in Greece the last 20 years and offers an treatment alternative for intraperitoneal metastasis from the ovaries, colon, rectum, appendix, stomach and mesothelioma, in the absence of cancer spread outside the abdominal cavity.
Missed cancer surgery figures are ‘wake-up call’ for healthcare systems.
’’It involves the surgical removal of all visible cancer growth and organs with cancerous growth, followed by the circulation of heated chemotherapy agents directly inside the abdominal cavity for minutes at a temperature of 42,5oC. Heating the chemotherapy agent increases the penetration of chemotherapy into the cancer cells, thus increasing the efficacy of chemotherapy treatment’’.
While the patient must be medically fit and able to tolerate anaesthesia and surgery, the success rate of the surgery depends on the burden of disease and the completeness of surgical resection, Dr Spiliotis said.
In the European Interbalkan Medical Center, Thessaloniki, Greece (one of the 27 centers of excellent all around the world recognized by European school of Peritoneal Surface Oncology) and in Athens Medical center, Athens Greece we performed 60 cases/year.
During the last 5 years in our center we performed 310 CRS+Hipec from Ovarian Cancer 150 cases, Colon Cancer 65 cases, gastric Cancer 20 cases, pseudomyxoma 40, Mesothelioma 25 and other tumors 10.
The morbidity was 19% and the mortality rate 2,4%.
The median survival rate was
- 38 months for Ovarian Cancer
- 34 months for Colorectal Cancer
- 46 months for Pseudomyxoma and
- 37 months for mesothelioma
The experience of our group the last 17 years (under Dr Spiliotis direction) with 1000 cases of CRS+HIPEC demonstrates that with proper patients selection (Low PCI, good performance status, prophylactic protocols, best pre-operative strategies) we can achieved excellent results.
In conclusion HIPEC truly makes a difference to the patient’s quality of life, and we highly recommend it to patients who are eligible for this type of treatment.
- The success rate of the surgery depends on the burden of disease and the completeness of surgical resection. The best-case scenario is small volume of disease and complete surgical resection of all visible disease.
- Following HIPEC, the patients continues his/her planned surveillance in the form of clinical follow-up, blood tests, and imaging mainly computerized tomography scans depending on the primary cancer and always some type of adjuvant systemic chemotherapy or immunotherapy.
- Most studies confirm that HIPEC improves quality of life and increases survival by an average of 20 to 30 months.
John D. Spiliotis MD, PhD, FASPSM
Director of the 4th Surgery Clinic at the Inter-Balkan Center of Thessaloniki
Athens-Maroussi Medical Center
European School of Peritoneal Surface Oncology (ESPSO)