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Hyperthermic Intraperitoneal Chemotherapy: A Critical Review.

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Heated intraperitoneal chemotherapy (HIPEC) offers high tumor concentrations for peritoneal metastases. However, inconsistent techniques and trial results mean its true value in treating peritoneal malignancies remains debated.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Peritoneal metastases are increasingly recognized but have a poor prognosis with traditional treatments.
  • Intraperitoneal chemotherapy offers high local drug concentrations with limited systemic exposure.
  • Heated intraperitoneal chemotherapy (HIPEC) was developed to enhance chemotherapy's anti-tumor effects.

Purpose of the Study:

  • To critically review the theoretical basis, preclinical, and clinical evidence for HIPEC in treating peritoneal malignancies.
  • To identify areas of uncertainty regarding HIPEC's efficacy and standardization.
  • To propose a framework for defining HIPEC's role in managing peritoneal metastases.

Main Methods:

  • Review of theoretical concepts, preclinical data, and clinical trial results.
  • Analysis of studies on heated intraperitoneal chemotherapy (HIPEC) for peritoneal metastases.
  • Critical evaluation of existing literature and clinical experience.

Main Results:

  • HIPEC has become a recognized treatment for peritoneal metastases, with increasing global adoption.
  • Significant variability exists in HIPEC techniques and protocols worldwide.
  • Clinical trial results for HIPEC have been equivocal, leading to ongoing debate about its definitive value.

Conclusions:

  • The effectiveness of heated intraperitoneal chemotherapy (HIPEC) for peritoneal malignancies requires further clarification.
  • Standardization of HIPEC techniques is crucial for consistent and interpretable clinical outcomes.
  • Further research and a structured approach are needed to establish the precise role of HIPEC in oncology.