What to Know About HIPEC Eligibility For Women With Ovarian Cancer

Hyperthermic (heated) intraperitoneal chemotherapy, or “HIPEC” for short, is a treatment method for ovarian cancer that can offer improved survival outcomes. It’s a complex procedure that may not be offered at all cancer centers. HIPEC is an improvement on an earlier, similar treatment called IP (intraperitoneal) chemotherapy, or “belly bath” chemo.

HIPEC: Heated Chemotherapy Treatment Following Surgery

HIPEC is one of the most important advances in ovarian cancer treatment. It’s usually given along with initial debunking surgery, but only if a surgeon has been able to remove (or debulk) all visible disease to a size of less than one centimeter. That’s because the treatment is unable to penetrate larger tumors.

For a HIPEC infusion, tubes of heated chemotherapy drugs are administered directly into the abdomen and circulated for about 90 minutes, delivering a strong, direct dose of chemo in the hopes of killing any remaining cancer cells that were not able to be removed during surgery.

This type of targeted treatment is optimal for ovarian cancer, as well as for colorectal and gastric cancers, which often spread to the lining surfaces of the abdominal cavity.

“It’s really a chemotherapy treatment that follows a major surgery, and doesn’t change the procedure that much in and of itself,” says Dr. James Lilja, gynecologic oncologist at Bay Area Gynecology Oncology in San Jose, which has provided HIPEC services under clinical trial setting since 2006, and was the first in the state of California.

Dr. Lilja says that HIPEC does not add significantly more toxicity than a typical ovarian cancer surgery alone.

Eligibility for HIPEC Treatment

“Our clinical trial, just like any other clinical trial, has what’s called entry and exclusion criteria,” says Dr. Lilja. To qualify for treatment patients

• Must be under age 75
• Have no major medical problems that would prevent surgery
• Have disease limited to the abdominal cavity
• Have just one malignancy (for instance, you can’t have breast cancer at the same time)

Increased Survival Outcomes After 5 Years

“What I can say is that the evidence has mounted for ovarian cancer. Forty percent of our patients at five years have not recurred,” says Dr. Lilja. “And this seems to be regardless of the number of recurrences they’ve had prior to us entering them into the study. That’s pretty good—that’s a lot higher than the palliation we can achieve for standard chemotherapy alone. When we’re able to resect all the cancer and add HIPEC, we’re able to achieve that 40 percent, five-year survival.”

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