Tag Archives: cytoreductive surgery

Dr. Fernando Arias

the meat and potatoes of HIPEC

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So I have returned to the United States and back on assignment for the next couple of months, so it’s time to get down to business.

A couple of new HIPEC articles came out – which I thought readers might enjoy.  For lighter fare, we will start with an article from the Vancouver Sun.

The first article, by Erin Ellis of the Vancouver Sun, is a Canadian fluff piece complete with sensationalistic headlines and dramatic patient interviews designed to draw attention to Vancouver General Hospital’s new HIPEC program.

 Dr. Fernando Arias

Dr. Fernando Arias, Chief of the HIPEC program at Santa Fe de Bogotá

Now for the meat and potatoes

The second article, which is more academically and scientifically based, is  focused on a study presented at the Southern Surgical Association  in December by Levine, et. al. (2014) “Intraperitoneal Chemotherapy for Peritoneal Surface Malignancy: Experience with 1,000 Patients” looks at long-term survival with HIPEC in patients with disseminated peritoneal malignancies.  This study is remarkable for both the duration of the prospective study (which began in 1991) and the large amount of participants for a single site study.  The vast majority of patients enrolled in this study had appendiceal cancer as their primary, but the study also included patients with ovarian, gastric, mesothelioma and colorectal cancers.

The evolution of the procedure and institutional experience led to improved outcomes and reduced complications over the course of the study.  Part of this was due to the development of better patient selection criteria.

This information comes as a ray of hope for patients with these diagnoses and previously given only dismal prognoses.

Dr. Edward Levine, the primary investigator, is the Chief of Surgical Oncology and Director of the Comprehensive Cancer Center at Wake Forest Medical Center in North Carolina.

It was published in the Journal of the American College of Surgeons, and summarized here, at Heme/Onc Today

Levine, et. al. (2014).  Intraperitoneal Chemotherapy for Peritoneal Surface Malignancy: Experience with 1,000 Patients.  Journal of the American College of Surgeons, 218(4): 573–585 (April 2014).  No free text available.

Additional HIPEC posts: the HIPEC archives 

HIPEC: the latest research results

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If you remember, previous New York Times articles questioned the efficacy of hyperthermic chemotherapy given during cytoreductive surgery.  We promised to investigate, and return with more results to this question.

Recently several articles have been published on the topic, including this one – in the journal of Clinical Oncology.  This narrative by Maurie Markman talks about the quick dismissal of HIPEC by many oncologists, particularly for larger tumors – and he questions the wisdom of this approach in light of recent research results.

In fact, several large new American studies – including one at Case Western are examining the use of HIPEC, particularly in gynecological cancers like ovarian and uterine cancers which carry a dismal prognosis.

American Hospitals are finally jumping on the HIPEC bandwagon…

Detroit hospital offering HIPEC

Atlanta docs, robots and HIPEC

This last link isn’t really news – it’s a press release, but since it’s on a surgical oncologist (Dr. Wilbur Bowne) who was an early American adopter of HIPEC, I thought readers might be interested.

Previous Bogota Surgery posts on HIPEC

HIPEC: The basics

Bogota Surgeons stay ahead of the curve

The Future is Now: HIPEC

Looks like it’s about time to check in with our favorite surgical oncologist, and HIPEC expert, Dr. Fernando Arias..

Check back soon for more..

New article on HIPEC

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There’s a new article on the HIPEC procedure that’s a nice read for people interested in this procedure.  The article is unrelated to medical tourism – it’s about the first application of hyperthermic intraperitoneal chemotherapy at a private facility in India.  (As you can imagine – I wouldn’t recommend that anyone have a procedure at a facility where doctors have just started trialling the technique.) That being said – the article gives a nice overview of the procedure itself.