Hyperthermic intraperitoneal chemotherapy (HIPEC) for gynecological cancer

Abstract

Aim Hyperthermic intraperitoneal chemotherapy (HIPEC) is a method of administering anticancer agents directly while heating the abdominal cavity. The aim of this review is to know the current position of HIPEC in ovarian cancer and uterine sarcoma and its future prospects. Methods This article reviews the current literature and evidence for the clinical trial of HIPEC in ovarian cancer and uterine sarcoma with consideration of the cases treated in our department. Results In January 2018, van Driel et al. reported the results of their phase 3, randomized, controlled trial and the usefulness of neoadjuvant chemotherapy followed by interval debulking surgery. With respect to greater than grade 3 complications, such as suture failure, intestinal perforation, postoperative bleeding, wound issues and death, there were no significant differences between the HIPEC group and the no‐HIPEC group. In a meta‐analysis including two randomized, controlled studies and 11 observational studies in 2019, the addition of HIPEC to cytoreductive surgery significantly improved overall survival of ovarian cancer patients. Moreover, growing evidence of the efficacy of cytoreductive surgery with HIPEC has also been reported in uterine sarcoma with peritoneal sarcomatosis in a multi‐institutional study. HIPEC could be one of the new therapeutic strategies for such disseminated peritoneal lesions. Conclusion Since the usage regimen and temperature setting of HIPEC are not standardized, and its effectiveness and adverse events are greatly affected by the time of administration, it is necessary to consider clinical trials for the optimization and establishment of HIPEC in Japan in the future.

Hyperthermia enhances the efficacy of chemotherapeutic drugs in heat-sensitive cells through interfering with DNA damage repair

“…There is much clinical experimental data demonstrating that the survival of patients with ovarian cancer can be significantly prolonged by HIPEC (21). Indeed, the synergistic mechanisms of hyperthermia and chemotherapy is the focus of much research related to ovarian cancer treatment options (22).…”

Hyperthermic Intraperitoneal Chemotherapy in the Management of Gastric Cancer: A Narrative Review

“…HIPEC is a treatment strategy that, combined with surgery, aims to treat advanced cancers within the abdomen, such as colorectal cancer, gastric cancer, ovarian cancer, or peritoneal mesothelioma. Even though its usefulness was reported in several types of advanced cancers within the abdomen [ 68 , 69 , 70 ], it should be considered that the application of HIPEC is associated with a risk of several complications, including hematological toxicity, kidney failure, venous thromboembolism, and infections within the venous accesses and urinary tract [ 71 ]. Typical side effects include nausea, vomiting, fatigue, or weight loss, but those usually persist up to 3 months after surgery.…”

Initial Experience of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Baltic Country Center

“…Some studies showed that patients with stage III epithelial ovarian cancer may benefit from HIPEC after CRS in terms of increased OS and recurrence-free survival [ 17 ]. However, the lack of robust evidence resulted in a decreased number of these procedures for ovarian cancer in our center [ 18 ].…”