{"entity":{"id":"hipec","kind":"technology","name":"HIPEC / PIPAC (intraperitoneal chemotherapy)","aka":[],"tldr":"Washing the abdominal cavity with heated chemotherapy during surgery to kill microscopic peritoneal deposits.","summary":"HIPEC exposes the peritoneal cavity directly to chemotherapy heated to 41-43 °C during cytoreductive surgery, achieving high local drug concentration and enhanced penetration into microscopic deposits. A survival benefit was shown in ovarian cancer at interval debulking (OVHIPEC-1) and in pseudomyxoma, but the result was negative in colorectal cancer (PRODIGE 7 for oxaliplatin HIPEC), so the evidence is mixed and indication-specific. PIPAC, pressurised intraperitoneal aerosol chemotherapy, is a palliative laparoscopic alternative for patients who are not candidates for full cytoreduction. Morbidity is substantial and outcomes depend on centre expertise. The simple version is a heated chemotherapy wash of the abdomen during surgery, which helps in some cancers and not others.","status":"established","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Hyperthermic_intraperitoneal_chemotherapy","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Hyperthermic_intraperitoneal_chemotherapy"},{"label":"Quenet, Lancet Oncol 2021: PRODIGE 7, cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases (265 patients)","url":"https://doi.org/10.1016/s1470-2045(20)30599-4"},{"label":"NICE NG151: colorectal cancer, recommendations (Lynch 1.1, local disease 1.3, biomarkers 1.4, metastatic disease 1.5, ongoing care and support including follow-up 1.6)","url":"https://www.nice.org.uk/guidance/ng151/chapter/Recommendations"}],"tags":[],"related":[],"cancers":["ovarian","colorectal","gastric","peritoneal-mesothelioma"],"sections":["chemotherapy","surgery"],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["colorectal-peritoneal-metastases"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":["The randomised result in colorectal peritoneal metastases: PRODIGE 7 added oxaliplatin hyperthermic intraperitoneal chemotherapy to complete cytoreductive surgery in 265 patients and found median overall survival of 41.7 against 41.2 months (hazard ratio 1.00), with more grade 3 or worse adverse events at 60 days in the hyperthermic arm (26 against 15 percent). Cytoreductive surgery alone is the cornerstone in this cancer (Quenet 2021); NICE NG151 (1.5.21) still routes these patients to a nationally commissioned specialist centre for the discussion."],"principle":"Direct peritoneal exposure at 41-43 °C enhances drug penetration.","strengths":["High local concentration"],"limitations":["Morbidity, centre expertise","Mixed trial results"]},"route":"/technologies/hipec/","neighbours":{"cancer":[{"id":"advanced-small-bowel-adenocarcinoma","kind":"cancer","name":"Advanced and metastatic small bowel adenocarcinoma","route":"/cancers/advanced-small-bowel-adenocarcinoma/"},{"id":"appendiceal-adenocarcinoma","kind":"cancer","name":"Appendiceal adenocarcinoma (mucinous and non-mucinous, including signet ring cell)","route":"/cancers/appendiceal-adenocarcinoma/"},{"id":"appendiceal","kind":"cancer","name":"Appendiceal cancer and pseudomyxoma peritonei","route":"/cancers/appendiceal/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"desmoplastic-small-round-cell-tumour","kind":"cancer","name":"Desmoplastic small round cell tumour","route":"/cancers/desmoplastic-small-round-cell-tumour/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"goblet-cell-adenocarcinoma","kind":"cancer","name":"Goblet cell adenocarcinoma of the appendix","route":"/cancers/goblet-cell-adenocarcinoma/"},{"id":"high-grade-serous-ovarian-cancer","kind":"cancer","name":"High-grade serous ovarian cancer","route":"/cancers/high-grade-serous-ovarian-cancer/"},{"id":"low-grade-appendiceal-mucinous-neoplasm","kind":"cancer","name":"Low-grade appendiceal mucinous neoplasm and pseudomyxoma peritonei","route":"/cancers/low-grade-appendiceal-mucinous-neoplasm/"},{"id":"mesothelioma","kind":"cancer","name":"Mesothelioma","route":"/cancers/mesothelioma/"},{"id":"ovarian","kind":"cancer","name":"Ovarian cancer","route":"/cancers/ovarian/"},{"id":"peritoneal-mesothelioma","kind":"cancer","name":"Peritoneal mesothelioma","route":"/cancers/peritoneal-mesothelioma/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"term":[{"id":"cytoreductive-surgery","kind":"term","name":"Cytoreductive surgery","route":"/terms/cytoreductive-surgery/"},{"id":"debulking","kind":"term","name":"Debulking (cytoreductive surgery)","route":"/terms/debulking/"},{"id":"hipec-procedure","kind":"term","name":"HIPEC (hyperthermic intraperitoneal chemotherapy)","route":"/terms/hipec-procedure/"},{"id":"intraperitoneal-chemotherapy","kind":"term","name":"Intraperitoneal (IP) chemotherapy","route":"/terms/intraperitoneal-chemotherapy/"},{"id":"peritoneal-carcinomatosis-index","kind":"term","name":"Peritoneal cancer index","route":"/terms/peritoneal-carcinomatosis-index/"},{"id":"colorectal-peritoneal-metastases","kind":"term","name":"Peritoneal metastases from bowel cancer","route":"/terms/colorectal-peritoneal-metastases/"},{"id":"peritoneal-metastasis","kind":"term","name":"Peritoneal metastasis","route":"/terms/peritoneal-metastasis/"},{"id":"systemic-vs-local-therapy","kind":"term","name":"Systemic versus local therapy","route":"/terms/systemic-vs-local-therapy/"}],"idea":[{"id":"idea-crc-peritoneal-disease-found-early-and-treated-in-networks","kind":"idea","name":"Find peritoneal spread while it is still small, and run complete cytoreduction through networks rather than adding heated chemotherapy","route":"/ideas/idea-crc-peritoneal-disease-found-early-and-treated-in-networks/"},{"id":"idea-fund-device-technique-registry","kind":"idea","name":"Mandatory staged registries for new surgical techniques before wide adoption","route":"/ideas/idea-fund-device-technique-registry/"},{"id":"idea-peritoneal-directed-gastric","kind":"idea","name":"Peritoneal-directed therapy for gastric cancer","route":"/ideas/idea-peritoneal-directed-gastric/"},{"id":"idea-bio2-intracavitary-immunotherapy","kind":"idea","name":"Treat the body cavity, not the bloodstream, for surface spread","route":"/ideas/idea-bio2-intracavitary-immunotherapy/"}],"trial":[{"id":"nct03280511","kind":"trial","name":"Adjuvant Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) in Resected High Risk Colon Cancer Patients","route":"/trials/nct03280511/"},{"id":"colopec","kind":"trial","name":"COLOPEC","route":"/trials/colopec/"},{"id":"nct04861558","kind":"trial","name":"Efficacy of Hyperthermic Intraperitoneal Chemotherapy","route":"/trials/nct04861558/"},{"id":"nct06783491","kind":"trial","name":"Efficacy of the Use of Neoadjuvant With/Without Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Locally Advanced Colon Cancer","route":"/trials/nct06783491/"},{"id":"netherlands-hipec","kind":"trial","name":"Netherlands Cancer Institute HIPEC trial","route":"/trials/netherlands-hipec/"},{"id":"ovhipec-1","kind":"trial","name":"OVHIPEC-1","route":"/trials/ovhipec-1/"},{"id":"nct02758951","kind":"trial","name":"Perioperative Systemic Therapy for Isolated Resectable Colorectal Peritoneal Metastases","route":"/trials/nct02758951/"},{"id":"nct07271355","kind":"trial","name":"Pressurized Intraperitoneal Aerosolized Chemotherapy With Mitomycin for the Treatment of Unresectable Appendix or Colorectal Cancer With Peritoneal Metastases,","route":"/trials/nct07271355/"},{"id":"prodige-7","kind":"trial","name":"PRODIGE 7","route":"/trials/prodige-7/"},{"id":"nct06839092","kind":"trial","name":"Prophylactic PIPAC in Patients With High-risk Colorectal Cancer","route":"/trials/nct06839092/"},{"id":"prophylochip","kind":"trial","name":"PROPHYLOCHIP-PRODIGE 15","route":"/trials/prophylochip/"},{"id":"nct06681038","kind":"trial","name":"Systemic Antitumor Treatment with or Without Pressurized Intraperitoneal Aerosol Chemotherapy for Colon Peritoneal Metastases (PIPOX02)","route":"/trials/nct06681038/"}],"pairing":[{"id":"hipec-at-interval-surgery","kind":"pairing","name":"HIPEC at interval cytoreductive surgery","route":"/pairings/hipec-at-interval-surgery/"}],"paper":[{"id":"paper-quenet-prodige-7-hipec-peritoneal-colorectal-lancet-oncol-2021","kind":"paper","name":"Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7)","route":"/key-papers/paper-quenet-prodige-7-hipec-peritoneal-colorectal-lancet-oncol-2021/"},{"id":"paper-verwaal-cytoreduction-hipec-peritoneal-colorectal-jco-2003","kind":"paper","name":"Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer","route":"/key-papers/paper-verwaal-cytoreduction-hipec-peritoneal-colorectal-jco-2003/"}],"roadmap":[{"id":"colorectal-roadmap","kind":"roadmap","name":"Colorectal cancer roadmap: from the adenoma-carcinoma sequence and the first screening trials to total mesorectal excision, oxaliplatin, RAS testing, immunotherapy for mismatch repair-deficient disease, ctDNA-guided treatment and organ preservation","route":"/roadmaps/colorectal-roadmap/"},{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}],"institution":[{"id":"esgo","kind":"institution","name":"European Society of Gynaecological Oncology","route":"/institutions/esgo/"},{"id":"esso","kind":"institution","name":"European Society of Surgical Oncology","route":"/institutions/esso/"},{"id":"sysu-first-affiliated-hospital","kind":"institution","name":"First Affiliated Hospital of Sun Yat-sen University","route":"/institutions/sysu-first-affiliated-hospital/"},{"id":"int-milan","kind":"institution","name":"Fondazione IRCCS Istituto Nazionale dei Tumori","route":"/institutions/int-milan/"},{"id":"sso","kind":"institution","name":"Society of Surgical Oncology","route":"/institutions/sso/"}],"person":[{"id":"willemien-van-driel","kind":"person","name":"Willemien J. van Driel","route":"/people/willemien-van-driel/"}],"drug":[{"id":"mitomycin","kind":"drug","name":"Mitomycin C","route":"/drugs/mitomycin/"}],"pathway":[{"id":"organ-tropism-seed-soil","kind":"pathway","name":"Organ tropism: seed and soil","route":"/pathways/organ-tropism-seed-soil/"}],"company":[{"id":"belmont-medical-technologies","kind":"company","name":"Belmont Medical Technologies","route":"/companies/belmont-medical-technologies/"},{"id":"capnomed","kind":"company","name":"Capnomed (Reger Medizintechnik)","route":"/companies/capnomed/"},{"id":"unicancer","kind":"company","name":"UNICANCER","route":"/companies/unicancer/"}],"technology":[{"id":"hipec-pipac-devices","kind":"technology","name":"HIPEC perfusion pumps and PIPAC nebulisers","route":"/technologies/hipec-pipac-devices/"}]}}