Hyperthermic intraperitoneal chemotherapy: Ideal and reality.

Area of Science:

• Oncology
• Surgical Oncology
• Adjuvant Therapies

Background:

• Hyperthermic Intraperitoneal Chemoperfusion (HIPEC) is an advanced adjuvant therapy for abdominal malignancies.
• HIPEC utilizes thermal chemotherapy and large-volume perfusion to eliminate residual disease, reducing ascites and recurrence risk.

Purpose of the Study:

• To summarize clinical challenges in HIPEC implementation.
• To explore areas for improvement and suggest standardization strategies for HIPEC technology.

Main Methods:

• Review of clinical practice issues in HIPEC.
• Identification of problems in perfusate distribution, surgical completeness, and catheter function.
• Analysis of challenges in technique selection, personnel safety, and chemotherapy regimen choice.

Main Results:

• Identified key operational problems including non-uniform temperature distribution, perfusion 'dead spaces', incomplete cytoreductive surgery (CRS), and catheter obstruction.
• Highlighted issues with standardized technique selection, occupational exposure risks, and tumor-specific chemotherapy regimen choices.
• Recognized the need for improved standardization in HIPEC procedures.

Conclusions:

• HIPEC shows significant promise but faces practical operational challenges.
• Addressing identified issues can lead to improved standardization and normalization of HIPEC technology.
• Further research and guideline development are needed to optimize HIPEC outcomes.