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Review
. 2016 Feb;7(1):18-28.
doi: 10.3978/j.issn.2078-6891.2015.106.

Then and now: cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), a historical perspective

Madalyn G Neuwirth  1 , H Richard Alexander  1 , Giorgos C Karakousis  1
Affiliations
Review

Then and now: cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), a historical perspective

Madalyn G Neuwirth et al. J Gastrointest Oncol. 2016 Feb.

Abstract

The management of peritoneal carcinomatosis, once considered a condition with few therapeutic options, has undergone dramatic change with the advancement of surgical techniques and systemic cancer therapy. Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) administration, in particular, has significantly impacted the prospect of improving outcomes for this debilitating presentation of malignancy in selected patients. This regional surgical therapy itself has undergone many stages of evolution through its original conception nearly a century ago. Progressive changes in this field have included refinements and ongoing standardization in technique, development of a common language to describe tumor burden and extent of resection, better selection of chemotherapeutics based on tumor histology, reduction of surgical morbidity and mortality, and an improved understanding of factors for appropriate patient selection, to list but a few examples. CRS/HIPEC continues to play an important role in the management of select patients with carcinomatosis of certain tumor histology and its role will no doubt continue to be redefined as new therapies emerge.

Keywords: Hyperthermic; carcinomatosis; chemotherapy; cytoreductive; intraperitoneal.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Timeline of achievements detailing evolution of HIPEC with CRS. Some of these historical events summarized in Roviello et al. (1). HIPEC, hyperthermic intraperitoneal chemotherapy; CRS, cytoreductive surgery.
Figure 2
Figure 2
Open “Coliseum” technique. From Sugarbaker PH, Yu W, Yonemura Y, et al. Gastrectomy, peritonectomy, and perioperative intraperitoneal chemotherapy: The evolution of treatment strategies for advanced gastric cancer. Semin Surg Oncol 2003;21:233-48, with permission (35).
Figure 3
Figure 3
Closed technique. From Boutros et al. World Journal of Surgical Oncology 2010;8:72. doi:10.1186/1477-7819-8-72, with permission (37).
See this image and copyright information in PMC

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