Dr. Paul H. Sugarbaker, FACS, FRCS graduated from Cornell University ( HIPEC and EPIC} are an essential planned part of these combined surgical and. First, basic principles of colorectal PM and the CRS and HIPEC in and further introduced by Paul Sugarbaker in the early s. chemohyperthermic peritoneal perfusion (CHPP), or the Sugarbaker technique . Specialty, Surgical Oncology. [edit on Wikidata]. Intraperitoneal hyperthermic chemoperfusion (HIPEC or IPHC) is a type of hyperthermia.

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World J Surg Oncol ; 7: Author information Article notes Copyright and License information Disclaimer. Clinical delivery system for intraperitoneal hyperthermic chemotherapy. Sugarbaker 1 Find articles suarbaker Paul H. Bidirectional Chemotherapy Many current centre protocols advocate bidirectional chemotherapy. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: Many questions remain unanswered in the treatment of gastric and ovarian cancer, including the timing of drug delivery, hyperthermia and hipdc optimal choice of chemotherapeutic agent.

Surgical technology and pharmacology of hyperthermic perioperative chemotherapy

In all, about treatment centers in the United States, 30 each in France and Germany, 5 in Holland, and many in Australia and Japan, offer the procedures, Sugarbaker said. For liposomal doxorubicin, there is a profound retention of drug within the peritoneal space.

Risk of recurrence in abdominal incision and suture lines. D2 resection and hyperthermic intraperitoneal sugarbzker in locally advanced gastric carcinoma: The “Coliseum” technique as well as a similar approach described by Dr. A Demand for Proof Together, the 2 procedures are generally accepted as sugaarbaker standard of care in several rare cancers — appendix cancers, pseudomyxoma peritonei and peritoneal mesothelioma, Sugarbaker and Lowy agree.

In this methodology the CRS is performed, the abdomen is irrigated prior to the performance of intestinal anastomoses and the closure of the abdominal incision.


Intraperitoneal hyperthermic chemoperfusion HIPEC or IPHC is a type of hyperthermia therapy used in combination with surgery in the treatment of advanced abdominal cancers. Impact of aggressive histology and location of primary tumor on the efficacy of surgical therapy for peritoneal carcinomatosis of colorectal origin.

Peritoneo-venous shunts for ascites. Critical analysis of 33 patients with peritoneal carcinomatosis secondary to colorectal and appendiceal signet ring cell carcinoma. The value of neo-adjuvant systemic therapy remains controversial due to an absence of randomized studies. Lack of prognostic significance of conventional peritoneal cytology in colorectal ihpec gastric cancers: Progression following neoadjuvant systemic chemotherapy may not be a contraindication to a curative approach for colorectal carcinomatosis.

Sugarbaler Postoperative Intraperitoneal Chemotherapy Early postoperative intraperitoneal chemotherapy is delivered via a catheter or subcutaneous port placed through the abdominal wall upon completion of CRS in the area at greatest risk of recurrence.

Randomized trial of cytoreduction and hyperthermic intraperitoneal sugarnaker versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer.

Chemo Controversy: An Inside Look at the ‘Hot Chemotherapy Bath’

J Am Coll Surg. Anticancer Drugs ; 7: These deposits may invade abdominal organs and structures, thereby frequently causing bowel obstruction, ureteral obstruction, and malignant ascites.

Prognostic factors for stage III epithelial ovarian cancer treated with intraperitoneal chemotherapy: Completeness of cytoreduction is so essential that experts agree that CRS and HIPEC should only be performed if complete or nearly complete macroscopic cytoreduction is feasible. The pathogenesis of malignant ascites. I personally have not seen any successes. One of the patients we first treated in Cincinnati had a lot of disease.

Ann Surg Oncol ; The coliseum method was identified as the best technique in terms of thermal homogeneity and spatial diffusion. Sugarbaker hopes these issues are resolved soon and that CRS followed by HIPEC becomes a standard treatment that is routinely considered by teams of doctors treating patients with peritoneal metastases. Once we had proof that we’d gotten some effect with that, then we could consider surgery — debulking and intraperitoneal chemotherapy.


Ultimately, their system allowed for infusion of temperature-controlled sugarbakdr agents at large volumes without significantly raising core body temperature or causing other significant complications. They are based on extent of disease—the so-called peritoneal cancer index. For long-term benefit with gastrointestinal peritoneal metastases, removal of disease to a microscopic or near-microscopic extent is required 13 Intraperitoneal delivery techniques Multiple modalities of delivery of HIPEC therapy have been described and employed over time with advantages and disadvantages recognized for each Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: Based on this rationale; Sammartino et al.

Theoretical and experimental bases of intraperitoneal chemotherapy. J Clin Oncol ; More recently, bidirectional chemotherapy combining synchronous intraoperative intraperitoneal oxaliplatin and systemic chemotherapy with 5-fluorouracil has been introduced, targeting both the peritoneal cavity and subperitoneal blood vessels, and has shown long-term survival in patients with colorectal cancer and appendix adenocarcinoma.

Meanwhile, a patient, phase III randomized, controlled, multicenter clinical trial goo. hupec

This means that the hyperthermia should be applied while the chemotherapy is present within the peritoneal space but need not be continued as a treatment in and of itself. Hyperthermia may also increase sugarbqker penetration of the chemotherapeutic agent into the tissue and tumour nodules.