What Is HIPEC?
HIPEC — hyperthermic intraperitoneal chemotherapy — is a procedure in which heated chemotherapy solution (40–42°C) is circulated directly within the abdominal cavity immediately after cytoreductive surgery. The heat enhances drug penetration into residual microscopic cancer deposits on the peritoneal surface, while the localised delivery limits the systemic side effects of chemotherapy.
Why HIPEC Matters for Ovarian Cancer
Advanced ovarian cancer frequently spreads across the peritoneum — the membrane lining the abdominal cavity. Even after optimal cytoreductive surgery removes all visible tumour, microscopic residual disease on the peritoneal surface is what drives recurrence. Systemic intravenous chemotherapy has limited penetration into peritoneal deposits. HIPEC addresses this gap directly.
The landmark OVHIPEC-1 trial (published in the New England Journal of Medicine, 2018) demonstrated that adding HIPEC with cisplatin to interval cytoreductive surgery in Stage III ovarian cancer improved median recurrence-free survival from 10.7 months to 14.2 months, and median overall survival from 33.9 months to 45.7 months — a clinically meaningful benefit.
The HIPEC Procedure: Step by Step
- Cytoreductive surgery — all visible tumour is removed, including omentectomy, peritoneal stripping, and any organ resection required to achieve complete cytoreduction (R0)
- Perfusion circuit setup — inflow and outflow catheters are placed in the abdominal cavity, connected to a closed-circuit heating machine
- HIPEC delivery — heated cisplatin solution is circulated at 40–42°C for 90 minutes while the abdomen is gently rocked to ensure even distribution
- Drainage and closure — the chemotherapy solution is drained, the abdomen is irrigated, and the incision is closed
Who Is a Candidate for HIPEC?
HIPEC is not appropriate for every ovarian cancer patient. The strongest evidence supports its use in:
- Stage III ovarian cancer undergoing interval cytoreductive surgery after neoadjuvant chemotherapy
- Patients in whom complete or optimal cytoreduction can be achieved
- Patients with adequate performance status (ECOG 0–1) and organ function
HIPEC adds approximately 90 minutes to the overall surgical time and does increase the complexity of post-operative care. Hospital stay is typically 7–10 days. Patients should be managed at centres with dedicated HIPEC infrastructure and multidisciplinary oncology support.
HIPEC is available at Dr. Nishtha Tripathi Patel’s practice in Ahmedabad. Patients in Gujarat and western India no longer need to travel to Mumbai or abroad. Contact: +91 76988 00333.