Developing a hyperthermic intraperitoneal chemotherapy (HIPEC) gynecologic oncology program: a Canadian experience

Area of Science:

• Oncology
• Surgical Oncology
• Pharmacology

Background:

• Epithelial ovarian cancer often spreads within the peritoneal cavity, making it a target for intraperitoneal chemotherapy.
• Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option following cytoreductive surgery for ovarian cancer.
• Evidence supports HIPEC's role in improving survival for stage III ovarian cancer patients.

Purpose of the Study:

• To review the evidence supporting HIPEC for epithelial ovarian cancer.
• To guide the development of successful HIPEC programs.
• To address perceived barriers to HIPEC implementation.

Main Methods:

• Review of recent studies and meta-analyses on HIPEC in ovarian cancer.
• Analysis of morbidity, cost-effectiveness, and resource requirements.
• Discussion of preoperative, anesthetic, surgical, and postoperative considerations.

Main Results:

• HIPEC has demonstrated improved overall survival in epithelial ovarian cancer patients.
• Morbidity is acceptable in selected patients, and HIPEC is cost-effective.
• Logistical and resource requirements are the primary barriers to HIPEC program implementation.

Conclusions:

• HIPEC is an effective treatment for ovarian cancer, improving survival.
• Challenges to HIPEC implementation can be overcome with proper planning and resources.
• Successful HIPEC programs require institutional commitment, a skilled team, and adequate infrastructure.