How effective is HIPEC?

The strongest support for the benefit of HIPEC therapy in treating patients with carcinomatosis comes from a randomized trial originally published in 2003 from the Netherlands (References:1). In this trial 105 patients with carcinomatosis from colorectal cancer had either 1) treatment with intravenous chemotherapy alone, or 2) surgical debulking, HIPEC, and then intravenous chemotherapy.  The results showed a doubling of median survival in the group treated with surgery and HIPEC to 22 months when compared to patients treated with intravenous chemotherapy alone that had a median survival of 13 months.  A follow-up publication from this group in 2008 confirmed these results.

More recently, other studies have demonstrated even longer survival in certain patients and an improvement in symptoms (References:2).  In light of the evidence that HIPEC has the potential to increase survival, a recently-published consensus statement reported that HIPEC should be considered the standard-of-care for patients with colorectal cancer metastases confined to the peritoneal cavity (References:3).

The data to support the use of HIPEC in cancers other than colorectal cancers is more limited.  However, smaller trials done in other cancer types suggest that survival can be improved as long as a complete cytoreduction can be obtained.