HIPEC is an acronym in English that stands for Hyperthermic Intraperitoneal Chemotherapy. It began to be studied in the late 1980s and early 1990s and involves infusing a solution containing saline and chemotherapy into the abdomen. This solution is then heated above 40 degrees Celsius and circulated within the abdominal cavity.
With this technique, it is possible to use a very high dose of chemotherapy, a dose that would be lethal if administered directly into the vein. However, when done inside the abdominal cavity, it is very safe because the muscle wall acts as a barrier, and only a minimal amount enters the bloodstream.
Additionally, heating this solution increases its “toxicity” to tumor cells, meaning the chemotherapy becomes more potent. Once again, it would not be possible to infuse heated chemotherapy into the vein.
The peritoneum is a membrane that lines the muscle wall and organs within the abdomen. When chemotherapy is traditionally infused into the vein, the peritoneum acts as a shield for the tumor, which remains hidden and protected on the other side. This is why intravenous chemotherapy has limited penetration into the nodules of peritoneal carcinomatosis, and traditional treatments have little effect, especially in diseases like pseudomyxoma.
HIPEC addresses these issues because the chemotherapy is infused “from the other side” and is better absorbed by the tumor.
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