Treatment after HIPEC and results

Although the HIPEC procedure is performed with the intent to cure a patient, it should be realized that peritoneal cancer is an aggressive disease, which often recurs even after a successful HIPEC-procedure. Prognosis after HIPEC is influenced by many factors such as the origin and the extent of the disease at the time of diagnosis, the possibility to remove all visible cancer during surgery and the condition of the patient. Certainly not all patients are cured after a HIPEC-procedure but generally speaking, survival after HIPEC is expressed in years rather than in months. Cure may be achieved in select patients.

To further improve outcomes after HIPEC, the treating physician may advise additional systemic chemotherapy. Such chemotherapy, which is typically started four to six weeks after the HIPEC procedure, is administered by infusion and/or pills. The aim of the chemotherapy is to prevent or delay peritoneal recurrence and metastatic spread to other organs, such as the liver or lungs. The medical term for chemotherapy in this situation is “adjuvant chemotherapy”.

Chemotherapy is not beneficial for every patient following HIPEC, and the decision to pursue chemotherapy depends on many factors that should be considered in every individual patient.

Patients may encounter specific problems and may have questions years after HIPEC. Therefore, close follow-up by a physician with knowledge of peritoneal cancer and HIPEC is highly desirable during this period. The results after HIPEC in terms of survival-benefit vary widely among patients. For example, results depend on origin of the peritoneal cancer and the extent of the disease at the time of diagnosis.

In general, prognosis of patients with pseudomyxoma peritonei in whom complete removal of the tumor can be achieved is good after HIPEC and the majority of such patients may even be cured. Cure is less often achieved in colorectal cancer patients and those with malignant mesothelioma but generally speaking, survival after HIPEC in these patients is expressed in years rather than in months as used to be the case with other treatments.

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