Heated Intraoperative Peritoneal Chemotherapy (HIPEC)

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Overview

The peritoneum, or lining of the abdomen, can be viewed as an organ of its own, with its own special challenges when cancer strikes. 
 
City of Hope’s peritoneal surface malignancy team provides patients with a rare treatment option. Heated intraoperative peritoneal chemotherapy, or HIPEC, involves aggressive surgery for cancer followed by immediate delivery of chemotherapy to the peritoneum in a single procedure. The goal is to eliminate every trace of cancer possible.

What is HIPEC?

HIPEC is an alternative method of delivering chemotherapy. Instead of infusing the medications through a vein, the medical team circulates chemotherapy in the abdominal cavity at the time of surgery. This allows direct treatment of certain cancers which have spread throughout the abdomen, where there are fewer blood vessels to transmit chemotherapy as it is traditionally administered. 
 
Surgeons perform an extensive operation to remove all visible tumors. After this step, chemotherapy heated to 42 degrees Celsius is circulated in the abdomen for 60 to 90 minutes. The chemotherapy is then drained, and the surgeons complete the procedure. These operations take more than six hours to complete.

Why City of Hope?

City of Hope performs the highest volume of HIPEC procedures among medical centers in Los Angeles County. We are the only center in the county offering HIPEC for ovarian cancer and one of a few that offer less-invasive laparoscopic HIPEC.
 
This unparalleled level of experience and access is unique to City of Hope. And it begins with our collaborative team of compassionate experts. Patients benefit from our seamless integration of top-level practitioners in fields such as surgery, gynecology, medical oncology, interventional radiology, anesthesiology and intensive care. These experts work together to evaluate each case and decide the best course of treatment for each individual patient. 
 
The close coordination and patient-focused ethos of our peritoneal surface malignancy team is essential for offering a demanding procedure shown effective in providing long-term survival in select patients with peritoneal malignancies.

How does HIPEC work?

Even after surgeons remove all of the tumors that they can see, smaller tumors or microscopic clusters of cancer cells inevitably remain. HIPEC allows for treatment of the cancer that is left behind, including malignant cells hiding in areas that may not be accessible to the surgeons. 
 
By placing the chemotherapy directly into the abdomen, doctors can use a higher dosage of the medication. The heat helps as well: Chemotherapy is absorbed more effectively when hot, and malignant cells lack the ability to repair themselves in the face of high heat the way healthy cells can. The combination of heat and chemotherapy creates an especially lethal environment for cancer cells.
 
Studies are showing that HIPEC with aggressive surgery improves survival in some cancers when compared to traditional intravenous chemotherapy alone.

Which cancers can be treated with HIPEC?

Cancers that show spread only to the abdominal cavity may benefit from HIPEC.

At City of Hope, we currently treat cancers of the

Other cancers that may benefit from this procedure include peritoneal mesothelioma and some sarcomas.

How do I become a patient?

At City of Hope, our peritoneal surface malignancy team consists of a multidisciplinary group of experts. We are one of the busiest HIPEC centers in Southern California, and continue to push the envelope in treating these difficult cancers. The team will evaluate your case and present options. Not everyone will be a candidate for HIPEC, but other treatments may be available.
 

Meet Our Team

Surgical Oncology

 
Byrne Lee, M.D.
Chief, Upper GI and Mixed Tumor Surgery Service
Associate Clinical Professor, Division of Surgical Oncology, Department of Surgery
Surgical Oncologist
Duarte
I. Benjamin Paz, M.D., F.A.C.S.
Executive Vice Chair and Clinical Professor, Department of Surgery
Medical Director, Value Based Oncology Care
Surgical Oncologist
South Pasadena
Mustafa Raoof, M.D.
Assistant Clinical Professor, Department of Surgery
Surgical Oncologist
Duarte
 

Gynecologic Oncology

Mark Wakabayashi, M.D., M.P.H.
Chief, Division of Gynecologic Oncology, Department of Surgery
Co-director, Gynecological Oncology/Peritoneal Malignancy Program
Associate Clinical Professor, Department of Surgery
Gynecologic Oncology Surgeon
Duarte
Ernest S. Han, M.D., Ph.D., F.A.C.O.G.
Assistant Clinical Professor, Division of Gynecologic Oncology, Department of Surgery
Gynecologic Oncology Surgeon
Duarte, Palm Springs
Stephen J. Lee, M.D.
Assistant Clinical Professor, Division of Gynecologic Oncology, Department of Surgery
Gynecologic Oncology Surgeon
Duarte, South Pasadena
Thanh H. Dellinger, M.D.
Assistant Professor, Division of Gynecologic Surgery, Department of Surgery
Gynecologic Oncology Surgeon
Duarte, Glendora
Mehdi M. Kebria, M.D.
Assistant Clinical Professor, Division of Gynecologic Oncology, Department of Surgery
Gynecologic Oncologist Surgeon
Rancho Cucamonga, Corona

Medical Oncology

Marwan G. Fakih, M.D.
Professor, Department of Medical Oncology & Therapeutics Research
Associate Director for Clinical Investigations, Comprehensive Cancer Center
Co-director, Gastrointestinal Cancer Program
Medical Oncologist
Duarte
Vincent Chung, M.D., F.A.C.P.
Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research
Director Phase I Program
Medical Oncologist
Duarte
Joseph Chao, M.D.
Assistant Clinical Professor, Department of Medical Oncology & Therapeutics Research
Medical Oncologist
Duarte
Mihaela C. Cristea, M.D.
Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research
Medical Oncologist
Duarte
Edward Wenge Wang, M.D., Ph.D.
Assistant Professor, Department of Medical Oncology & Therapeutics Research
Duarte
Daphne B. Stewart, M.D.
Associate Clinical Professor, Department of Medical Oncology & Therapeutics Research
Medical Oncologist
Duarte
 

NURSE PRACTITIONER/ANCILLARY STAFF

Melissa Sideco
Duarte

Janelle Saluja
Duarte

Current Study Recruitment

City of Hope currently has a study to treat primary or recurrent carcinoma of ovarian, fallopian tube, uterine, or peritoneal origin with HIPEC after cytoreductive surgery.
 

As part of the study, Thanh H. Dellinger, M.D., and her colleagues are investigating quality-of-life outcomes for these patients, and the role of normothermic intraperitoneal chemotherapy following HIPEC.

Refer your patients for inclusion in our HIPEC study by calling 626-218-1934 or emailing Melissa Eng at [email protected] or Dia Parungao at [email protected].