Hyperthermic intraperitoneal chemotherapy – HIPEC (Hot Chemotherapy)

What is Hot Chemotherapy (HIPEC)?

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a cancer treatment method in which heated chemotherapy drugs are applied into the abdominal cavity for a certain period of time. HIPEC, also known as “hot chemotherapy,” is a surgical operation performed after removing tumors or lesions from the abdominal area. This process, which was first used in gastric and intestinal cancers, has been applied in ovarian cancer since 2016.

Why Hot Chemotherapy (HIPEC)?

Based on cell-based studies, we know that at increased temperature, cancer cells become more sensitive to certain chemotherapy agents, and these drugs increase their ability to destroy (cytotoxic effect) by penetrating cancer cells more effectively and deeply. The heat alone has an antitumoral effect. Moreover, by applying chemotherapy drugs directly into the abdomen, all the areas where the tumor is located can be reached. Compared to the systemic chemotherapy given to the bloodstream, side effects are less common in HIPEC since it is applied directly to the abdominal cavity. The chemotherapy dose may be higher than intravenously. Because it is not absorbed by the body in the same way. In this way, the normal side effects of chemotherapy can be avoided. In HIPEC, chemotherapy medication is applied throughout the abdomen with rapid circulation for approximately 70-90 minutes.

HIPEC is applied to eliminate microscopic tumor cells after the main surgical procedures (ie, after removing all tumor areas). HIPEC cannot replace the surgery that leaves no tumor behind, and this is the most important factor in ovarian cancer treatment, however it can improve the outcome of the disease when combined with an excellent surgery.

How is Hot Chemotherapy (HIPEC) Applied?

After all visible tumors are removed in the abdomen, four HIPEC catheters are inserted into the abdomen and the tips of these catheters are directed to special areas within the abdomen. The chemotherapy agents to be given are heated at 42 degrees Celsius in the HIPEC device and pumped into the abdominal cavity. This procedure takes about 70-90 minutes. The HIPEC procedure is designed to kill all remaining cancer cells that are not visible. The solution is then removed and the incision is closed.

HIPEC and ovarian cancer surgery should be performed especially by physicians experienced in this field. Our published experiences about HIPEC can be found in the literature. Furthermore, with HIPEC, we have been able to achieve morbidity rates compatible with the most advanced centers since 2018.


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