HIPEC hits its stride

When I first started reading and writing about HIPEC (after meeting Dr. Arias in Bogota), I was met with a lot of skepticism and sometimes even ridicule, primarily from American physicians.

Several of them derided HIPEC with a vehemence that was unexpected – a vigor that was quite surprising and almost venomous in nature.  I was accused of being ignorant, or more maliciously, a possible fraud or trickster – even when I explained my sources (scientific and medical journals) and reminded critics that I was on a fact-finding mission, not a sales pitch.

I don’t sell HIPEC.  I don’t sell any medical equipment, treatment, or procedures. I don’t market or sell surgeons.  About the only thing I sell  is the occasional copy of one of my books.

No – I don’t sell much.  Instead, I write, I research and I do my best to provide information, and resources to people who are interested in the same topics.  As a healthcare provider, my reasons for writing about these topics may very well differ from my readers – but that’s more perspective than anything else.

When it comes to HIPEC – I was attracted because HIPEC offers hope.  Not in a wild, faith-healing, magic pill , “100% absolutely guaranteed, for positively everyone” kind of way, but in a quiet, evolving medicine kind of way.. Meaning that we are still learning about it -and who it can help..

So it was disappointing to have that hope dimmed by other medical professionals, but then – sometimes procedures and treatments that sound promising DO end up disappointing.  So I’ve kept an eye on the research, and kept reading..

It’s been a on-going process.. Imagine my delight to see that over SIXTY articles have been published in medical & research journals on HIPEC in just the last six months.. Some with great results, some okay, – some detailing complications..

(I’ve posted some of the citations here).  Most of the articles aren’t free but there is a notation to the ones that are.

1. Intrapleural hyperthermic perfusion chemotherapy in subjects with metastatic pleural malignancies.
  Işık AF, Sanlı M, Yılmaz M, Meteroğlu F, Dikensoy O, Sevinç A, Camcı C, Tunçözgür B, Elbeyli L.
  Respir Med. 2013 May;107(5):762-7. doi: 10.1016/j.rmed.2013.01.010. Epub 2013 Feb 23.
  PMID: 23462236 [PubMed – in process]  This is actually HITHOC
  Related citations
2. Patients at risk for peritoneal surface malignancy of colorectal cancer origin: the role of second look laparotomy.
  Brücher B, Stojadinovic A, Bilchik A, Protic M, Daumer M, Nissan A, Itzhak A.
  J Cancer. 2013;4(3):262-9. doi: 10.7150/jca.5831. Epub 2013 Mar 15.
  PMID: 23459716 [PubMed] Free PMC Article
  Related citations
3. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis (HIPEC): the Danish experience.
  Iversen LH, Rasmussen PC, Hagemann-Madsen R, Laurberg S.
  Colorectal Dis. 2013 Mar 4. doi: 10.1111/codi.12185. [Epub ahead of print]
  PMID: 23458368 [PubMed – as supplied by publisher]
  Related citations
4. Complications and toxicities after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  Canda AE, Sokmen S, Terzi C, Arslan C, Oztop I, Karabulut B, Ozzeybek D, Sarioglu S, Fuzun M.
  Ann Surg Oncol. 2013 Apr;20(4):1082-7. doi: 10.1245/s10434-012-2853-x. Epub 2013 Mar 2.
  PMID: 23456387 [PubMed – in process]
  Related citations
5. The role of perioperative systemic chemotherapy in diffuse malignant peritoneal mesothelioma patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  Deraco M, Baratti D, Hutanu I, Bertuli R, Kusamura S.
  Ann Surg Oncol. 2013 Apr;20(4):1093-100. doi: 10.1245/s10434-012-2845-x. Epub 2013 Mar 2.
  PMID: 23456386 [PubMed – in process]
  Related citations
6. Extensive cytoreductive surgery for appendiceal carcinomatosis: morbidity, mortality, and survival.
  Wagner PL, Austin F, Maduekwe U, Mavanur A, Ramalingam L, Jones HL, Holtzman MP, Ahrendt SA, Zureikat AH, Pingpank JF, Zeh HJ, Bartlett DL, Choudry HA.
  Ann Surg Oncol. 2013 Apr;20(4):1056-62. doi: 10.1245/s10434-012-2791-7. Epub 2013 Mar 2.
  PMID: 23456385 [PubMed – in process]
  Related citations
7. Body surface area predicts plasma oxaliplatin and pharmacokinetic advantage in hyperthermic intraoperative intraperitoneal chemotherapy.
  Leinwand JC, Bates GE, Allendorf JD, Chabot JA, Lewin SN, Taub RN.
  Ann Surg Oncol. 2013 Apr;20(4):1101-4. doi: 10.1245/s10434-012-2790-8. Epub 2013 Mar 2.
  PMID: 23456384 [PubMed – in process] Free PMC Article
  Related citations
8. Assessment of neoadjuvant chemotherapy on operative parameters and outcome in patients with peritoneal dissemination from high-grade appendiceal cancer.
  Turner KM, Hanna NN, Zhu Y, Jain A, Kesmodel SB, Switzer RA, Taylor LM, Richard Alexander H Jr.
  Ann Surg Oncol. 2013 Apr;20(4):1068-73. doi: 10.1245/s10434-012-2789-1. Epub 2013 Mar 2.
  PMID: 23456383 [PubMed – in process]
  Related citations
9. Surveillance MR imaging is superior to serum tumor markers for detecting early tumor recurrence in patients with appendiceal cancer treated with surgical cytoreduction and HIPEC.
  Low RN, Barone RM, Lee MJ.
  Ann Surg Oncol. 2013 Apr;20(4):1074-81. doi: 10.1245/s10434-012-2788-2. Epub 2013 Mar 2.
  PMID: 23456382 [PubMed – in process]
  Related citations
10. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from rectal cancer.
  Votanopoulos KI, Swett K, Blackham AU, Ihemelandu C, Shen P, Stewart JH, Levine EA.
  Ann Surg Oncol. 2013 Apr;20(4):1088-92. doi: 10.1245/s10434-012-2787-3. Epub 2013 Mar 2.
  PMID: 23456381 [PubMed – in process]
  Related citations
11. Hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis: role of heat shock proteins and dissecting effects of hyperthermia.
  Pelz JO, Vetterlein M, Grimmig T, Kerscher AG, Moll E, Lazariotou M, Matthes N, Faber M, Germer CT, Waaga-Gasser AM, Gasser M.
  Ann Surg Oncol. 2013 Apr;20(4):1105-13. doi: 10.1245/s10434-012-2784-6. Epub 2013 Mar 2.
  PMID: 23456378 [PubMed – in process]
  Related citations
12. Risk factors for recurrence following complete cytoreductive surgery and HIPEC in colorectal cancer-derived peritoneal surface malignancies.
  Königsrainer I, Horvath P, Struller F, Forkl V, Königsrainer A, Beckert S.
  Langenbecks Arch Surg. 2013 Jun;398(5):745-9. doi: 10.1007/s00423-013-1065-6. Epub 2013 Mar 1.
  PMID: 23456355 [PubMed – in process]
  Related citations
13. Assessment of clinical benefit and quality of life in patients undergoing cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for management of peritoneal metastases.
  Zhu Y, Hanna N, Boutros C, Alexander HR Jr.
  J Gastrointest Oncol. 2013 Mar;4(1):62-71. doi: 10.3978/j.issn.2078-6891.2012.053.
  PMID: 23450068 [PubMed] Free PMC Article
  Related citations
14. Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) for palliative treatment of malignant ascites from gastrointestinal stromal tumours.
  Ong E, Diven C, Abrams A, Lee E, Mahadevan D.
  J Palliat Care. 2012 Winter;28(4):293-6. No abstract available.
  PMID: 23413766 [PubMed – indexed for MEDLINE]
  Related citations
15. A prospective multicenter phase II study evaluating multimodality treatment of patients with peritoneal carcinomatosis arising from appendiceal and colorectal cancer: the COMBATAC trial.
  Glockzin G, Rochon J, Arnold D, Lang SA, Klebl F, Zeman F, Koller M, Schlitt HJ, Piso P.
  BMC Cancer. 2013 Feb 7;13:67. doi: 10.1186/1471-2407-13-67.
  PMID: 23391248 [PubMed – in process] Free PMC Article
  Related citations
16. Heated intraperitoneal chemotherapy in appendiceal cancer treatment.
  Cianos R, Lafever S, Mills N.
  Clin J Oncol Nurs. 2013 Feb;17(1):84-7, 90. doi: 10.1188/13.CJON.84-87.
  PMID: 23372101 [PubMed – in process]
  Related citations
17. Aggressive locoregional management of recurrent peritoneal sarcomatosis.
  Baumgartner JM, Ahrendt SA, Pingpank JF, Holtzman MP, Ramalingam L, Jones HL, Zureikat AH, Zeh HJ 3rd, Bartlett DL, Choudry HA.
  J Surg Oncol. 2013 Mar;107(4):329-34. doi: 10.1002/jso.23232. Epub 2013 Feb 5.
  PMID: 23386388 [PubMed – indexed for MEDLINE]
  Related citations
18. A Phase I Trial of Thermal Sensitization Using Induced Oxidative Stress in the Context of HIPEC.
  Harrison LE, Tiesi G, Razavi R, Wang CC.
  Ann Surg Oncol. 2013 Jun;20(6):1843-50. doi: 10.1245/s10434-013-2874-0. Epub 2013 Jan 26.
  PMID: 23354567 [PubMed – in process]
  Related citations
19. Hyperthermic intraperitoneal chemotherapy with carboplatin for optimally-cytoreduced, recurrent, platinum-sensitive ovarian carcinoma: a pilot study.
  Argenta PA, Sueblinvong T, Geller MA, Jonson AL, Downs LS Jr, Carson LF, Ivy JJ, Judson PL.
  Gynecol Oncol. 2013 Apr;129(1):81-5. doi: 10.1016/j.ygyno.2013.01.010. Epub 2013 Jan 23.
  PMID: 23352917 [PubMed – indexed for MEDLINE]
1. Accuracy of MDCT in the preoperative definition of Peritoneal Cancer Index (PCI) in patients with advanced ovarian cancer who underwent peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC).
  Mazzei MA, Khader L, Cirigliano A, Cioffi Squitieri N, Guerrini S, Forzoni B, Marrelli D, Roviello F, Mazzei FG, Volterrani L.
  Abdom Imaging. 2013 Jun 7. [Epub ahead of print]
  PMID: 23744439 [PubMed – as supplied by publisher]
  Related citations
2. Cytoreductive surgery and intraperitoneal chemotherapy for treatment of peritoneal carcinomatosis from colorectal origin.
  Losa F, Barrios P, Salazar R, Torres-Melero J, Benavides M, Massuti T, Ramos I, Aranda E.
  Clin Transl Oncol. 2013 Jun 6. [Epub ahead of print]
  PMID: 23740133 [PubMed – as supplied by publisher]
  Related citations
3. Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent peritoneal metastases.
  Chua TC, Quinn LE, Zhao J, Morris DL.
  J Surg Oncol. 2013 Jun 5. doi: 10.1002/jso.23356. [Epub ahead of print]
  PMID: 23737041 [PubMed – as supplied by publisher]
  Related citations
4. Importance of standardizing the dose in hyperthermic intraperitoneal chemotherapy (HIPEC): a pharmacodynamic point of view.
  Mas-Fuster MI, Ramon-Lopez A, Nalda-Molina R.
  Cancer Chemother Pharmacol. 2013 Jun 5. [Epub ahead of print] No abstract available.
  PMID: 23736155 [PubMed – as supplied by publisher]
  Related citations
5. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma.
  Sun Y, Shen P, Stewart JH, Russell GB, Levine EA.
  Am Surg. 2013 Jun;79(6):644-8.
  PMID: 23711278 [PubMed – in process]
  Related citations
6. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in peritoneal sarcomatosis.
  Randle RW, Swett KR, Shen P, Stewart JH, Levine EA, Votanopoulos KI.
  Am Surg. 2013 Jun;79(6):620-4.
  PMID: 23711273 [PubMed – in process]
  Related citations
7. Prognostic Factors of Peritoneal Metastases from Colorectal Cancer following Cytoreductive Surgery and Perioperative Chemotherapy.
  Yonemura Y, Canbay E, Ishibashi H.
  ScientificWorldJournal. 2013 Apr 18;2013:978394. doi: 10.1155/2013/978394. Print 2013.
  PMID: 23710154 [PubMed – in process] Free PMC Article
  Related citations
8. Is there a role for intraperitoneal administration of heparin in hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis of colorectal cancer origin? Current data and future orientations.
  Seretis F, Seretis C.
  Med Hypotheses. 2013 May 13. doi:pii: S0306-9877(13)00221-1. 10.1016/j.mehy.2013.04.040. [Epub ahead of print]
  PMID: 23680001 [PubMed – as supplied by publisher]
  Related citations
9. The benefit of intraperitoneal chemotherapy for the treatment of colorectal carcinomatosis.
  Francescutti V, Rivera L, Seshadri M, Kim M, Haslinger M, Camoriano M, Attwood K, Kane JM 3rd, Skitzki JJ.
  Oncol Rep. 2013 Jul;30(1):35-42. doi: 10.3892/or.2013.2473. Epub 2013 May 15.
  PMID: 23673557 [PubMed – in process]
  Related citations
10. Clinical study of cisplatin hyperthermic intraperitoneal perfusion chemotherapy in combination with docetaxel, 5-flourouracil and leucovorin intravenous chemotherapy for the treatment of advanced-stage gastric carcinoma.
  Zhibing W, Qinghua D, Shenglin M, Ke Z, Kan W, Xiadong L, Pengjun Z, Ruzhen Z.
  Hepatogastroenterology. 2013 May 10;60(128). doi: 10.5754/hge13038. [Epub ahead of print]
  PMID: 23598741 [PubMed – as supplied by publisher]
  Related citations
11. Outcome of patients with aggressive pseudomyxoma peritonei treated by cytoreductive surgery and intraperitoneal chemotherapy.
  Arjona-Sanchez A, Muñoz-Casares FC, Casado-Adam A, Sánchez-Hidalgo JM, Ayllon Teran MD, Orti-Rodriguez R, Padial-Aguado AC, Medina-Fernández J, Ortega-Salas R, Pulido-Cortijo G, Gómez-España A, Rufián-Peña S.
  World J Surg. 2013 Jun;37(6):1263-70. doi: 10.1007/s00268-013-2000-2.
  PMID: 23532601 [PubMed – in process]
  Related citations
12. Treatment of peritoneal carcinomatosis from breast cancer by maximal cytoreduction and HIPEC: A preliminary report on 5 cases.
  Cardi M, Sammartino P, Framarino ML, Biacchi D, Cortesi E, Sibio S, Accarpio F, Luciani C, Palazzo A, di Giorgio A.
  Breast. 2013 Mar 21. doi:pii: S0960-9776(13)00053-2. 10.1016/j.breast.2013.02.020. [Epub ahead of print]
  PMID: 23523180 [PubMed – as supplied by publisher]
  Related citations
13. Primary peritoneal serous carcinoma treated by cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. A multi-institutional study of 36 patients.
  Bakrin N, Gilly FN, Baratti D, Bereder JM, Quenet F, Lorimier G, Mohamed F, Elias D, Glehen O; Association Française de Chirurgie.
  Eur J Surg Oncol. 2013 Mar 16. doi:pii: S0748-7983(13)00263-1. 10.1016/j.ejso.2013.02.018. [Epub ahead of print]
  PMID: 23510853 [PubMed – as supplied by publisher]
  Related citations
14. Impact of hyperthermic intraperitoneal chemotherapy on Hsp27 protein expression in serum of patients with peritoneal carcinomatosis.
  Kepenekian V, Aloy MT, Magné N, Passot G, Armandy E, Decullier E, Sayag-Beaujard A, Gilly FN, Glehen O, Rodriguez-Lafrasse C.
  Cell Stress Chaperones. 2013 Mar 19. [Epub ahead of print]
  PMID: 23508575 [PubMed – as supplied by publisher]
  Related citations
15. Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Asian Patients: 100 Consecutive Patients in a Single Institution.
  Teo MC, Tan GH, Tham CK, Lim C, Soo KC.
  Ann Surg Oncol. 2013 Mar 17. [Epub ahead of print]
  PMID: 23504144 [PubMed – as supplied by publsh
  Related citations
16. Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma.
  Alexander HR Jr, Bartlett DL, Pingpank JF, Libutti SK, Royal R, Hughes MS, Holtzman M, Hanna N, Turner K, Beresneva T, Zhu Y.
  Surgery. 2013 Jun;153(6):779-86. doi: 10.1016/j.surg.2013.01.001. Epub 2013 Mar 13.
  PMID: 23489943 [PubMed – in process]
  Related citations
17. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy as salvage treatment for a late wound recurrence of endometrial cancer.
  Santeufemia DA, Lumachi F, Basso SM, Tumolo S, Re GL, Capobianco G, Bertozzi S, Pasqual EM.
  Anticancer Res. 2013 Mar;33(3):1041-4.
  PMID: 23482779 [PubMed – indexed for MEDLINE]
  Related citations
18. Preoperative carcinoembryonic antigen level predicts prognosis in patients with pseudomyxoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  Canbay E, Ishibashi H, Sako S, Mizumoto A, Hirano M, Ichinose M, Takao N, Yonemura Y.
  World J Surg. 2013 Jun;37(6):1271-6. doi: 10.1007/s00268-013-1988-7.
  PMID: 23467926 [PubMed – in process]
  Related citations
19. Rhabdomyolysis after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a case report.
  Bielen R, Verswijvel G, Van der Speeten K.
  Case Rep Oncol. 2013 Jan;6(1):36-44. doi: 10.1159/000346471. Epub 2013 Jan 18.
  PMID: 23467441 [PubMed] Free PMC Article


Now that Case Western has decided to adopt HIPEC for treatment of gynecological cancers (uterine, ovarian, endometrial etc.) they have published an article patting themselves on the back.. 

But truthfully, not bad, case western, not bad at all.. It’s a good article with a nice explanation for people new to Hyperthermic Intraperitoneal Chemotherapy – (and I am always happy to see more state-of-the-art treatments offered to people with cancer.)

That’s one of the reasons we’ve championed HIPEC here at Bogota Surgery –  state-of-the-art cancer treatment with an excellent track record according to medical literature and published research.  Too often patients, particularly patients with cancer or other serious medical illnesses are preyed upon with junk or uncertain science, like super-vitamin supplement programs, Laetrile clinics and quasi-futuristic stem-cell therapies.

But HIPEC is different, and it’s been here for quite a while  – with over ten years worth of scientific data to support continued experimentation (large-scale) and use.

We first encountered HIPEC in Bogotá at the hands of Dr. Fernando Arias at Fundacion Santa Fe de Bogotá.  In our continued quest for information (see our series on HIPEC) – he continues to be at the forefront of HIPEC treatment with more experience than doctors like Dr. Trey Blazer at Duke, teams at Case Western, and the other scattered programs throughout the United States.  With the exception of its creator, Dr. David Sugarbaker – Dr. Arias has as much experience, evidence and training as anyone I’ve encountered..

See our tab labelled Cytoreductive Surgery for more on HIPEC

HIPEC: the latest research results

If you remember, previous New York Times articles questioned the efficacy of hyperthermic chemotherapy given during cytoreductive surgery.  We promised to investigate, and return with more results to this question.

Recently several articles have been published on the topic, including this one – in the journal of Clinical Oncology.  This narrative by Maurie Markman talks about the quick dismissal of HIPEC by many oncologists, particularly for larger tumors – and he questions the wisdom of this approach in light of recent research results.

In fact, several large new American studies – including one at Case Western are examining the use of HIPEC, particularly in gynecological cancers like ovarian and uterine cancers which carry a dismal prognosis.

American Hospitals are finally jumping on the HIPEC bandwagon…

Detroit hospital offering HIPEC

Atlanta docs, robots and HIPEC

This last link isn’t really news – it’s a press release, but since it’s on a surgical oncologist (Dr. Wilbur Bowne) who was an early American adopter of HIPEC, I thought readers might be interested.

Previous Bogota Surgery posts on HIPEC

HIPEC: The basics

Bogota Surgeons stay ahead of the curve

The Future is Now: HIPEC

Looks like it’s about time to check in with our favorite surgical oncologist, and HIPEC expert, Dr. Fernando Arias..

Check back soon for more..

The Future is Now – HIPEC in the news again..

Another article on the effectiveness of HIPEC (cytoreductive surgery with intraoperative hyperthermic chemotherapy) in the news.  This story comes out of India and highlights doctors there and the HIPEC procedure for treatment of abdominal cancers (intestinal and ovarian cancers.)

The Future is Now..  in an article on Medscape, dated December of 2010 and originally published in Future Oncology, Dr. Ze Lu et. al discusses the future of cancer treatment.  (The article is several pages in length – so I haven’t re-posted but reference information is provided below).  Dr. Ze Lu and his colleagues believe the future of oncology treatment is…. Intraperitoneal Hyperthermic Chemotherapy (HIPEC)..

In August, we’ll check back in with Bogotá’s resident expert on HIPEC, Dr. Fernando Arias.


Lu, Z., Wang, J.,  Wientjes, G., & Au, J. (2010).  Intraperitoneal therapy for peritoneal cancer.  Future Oncology. 2010 (6) 10; 1625 -1641