This highly specialized approach may be recommended for certain patients with advanced stomach cancer that has spread to the inner lining of the abdomen, which occurs in 20 to 30% of patients with stomach cancer.
What is CS/HIPEC?
This strange acronym refers to a complicated treatment that involves extensive surgery to remove the cancer, called cytoreduction surgery (CS), followed by delivering heated chemotherapy directly to the abdomen before the operation is completed, a process called hyperthermic intraperitoneal chemoperfusion (HIPEC).
After the surgeon removes all visible cancerous tumors from the abdomen, the abdominal cavity is saturated with a chemotherapy solution that is heated to 42 degrees Celsius. The solution bathes the abdomen for 90 minutes, directly killing microscopic cancer cells. Then the chemotherapy is allowed to drain out and the surgeon closes the abdomen.
Heating the chemotherapy improves uptake of the drugs, and by placing the chemotherapy solution directly into the abdomen, a much stronger concentration of the drugs can be used without the harmful side effects associated with allowing the drugs to circulate throughout the body.
Roswell Park’s CS/HIPEC expertise
Roswell Park has extensive experience with this complex approach and has performed CS/HIPEC since 2002. Not all patients with advanced disease are able to undergo this treatment. Among other criteria, patients must have disease that is isolated in the abdomen and be strong enough to tolerate an extensive and long surgery. CS/HIPEC is also used in the treatment of ovarian and colon cancers as well as mesothelioma.
We see a high number of patients with large tumors and advanced disease, so it requires a unique skill set to manage these tumors to get best survival and functional outcome.