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What Is Intraperitoneal Chemotherapy?

Intraperitoneal Chemotherapy, is a perfusion technique in which heated chemotherapy is administered directly into the abdomen during surgery. There are a few terms that apply to this technique of delivering chemotherapy, continuous hyperthermia peritoneal perfusion, heated intraoperative peritoneal chemotherapy, and HIPEC. Another term that is used is EPIC, this refers to extending the period of intraperitoneal chemotherapy beyond the operating room, Early Postoperative Inraperitoneal Chemotherapy. The way the technique works is that direct administration of heated chemotherapy in the peritoneal space provides an increase in the drug concentration in the peritoneum as opposed to receiving the chemotherapy through your veins or by mouth.

This technique has been developed over the years, in coordination with cytoreductive surgery. Cytoreductive surgery is removing all of the tumor evident to the eye. In 1934, Dr. Meigs of New York theorized that in locally advanced abdominal cancers, like ovarian cancer, that by resecting all he could see would reduce complications such as intestinal obstructions, perforation, ascites. Further treatment would then include post op radiation. This technique did not take hold until the late 1960’s and 1970’s. The evolvement of Cytoreductive surgery is important to the development of HIPEC as both procedures are used together.


 

The reports from the centers undergoing this procedure have been very encouraging. Survival for selected patients, with certain types of peritoneal mesothelioma has been encouraging.

Peritoneal mesothelioma is a very rare cancer and progress has been made with various techniques including HIPEC. The need for patients with peritoneal mesothelioma to go to one of the leading centers for peritoneal mesothelioma cannot be emphasized enough.

Dr. Brian Loggie is an expert in this technique having been one of the pioneer researchers in this since 1991 publishing his findings in an article – The American Surgeon, October 2001, Prospective Trial for the Treatment of Malignant Peritoneal Mesothelioma, by Brian W. Loggie, MD, Ronald A. Fleming, Pharm. D., Richard P. McQuellon, PhD, Gregory B. Russell, M.S., Kim R. Geisinger, M.D., Edward A. Levine, M.D. from the Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina.

The February 2016 edition of Journal of Gastrointestinal Oncology, “Then and now, cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC), a historical perspective” by Madalyn G. Neuwirth, H Richard Alexander, and Giorgos C. Karakousis is an excellent resource to review these techniques.
 

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Did You Know?

  • Mesothelioma Facts
    Mesothelioma Facts
    The highest award of compensatory damages ever upheld on appeal in a mesothelioma case is $30.3 million.
  • Mesothelioma Facts
    Mesothelioma Facts
    The largest punitive damages verdict ever upheld on appeal in a mesothelioma case is $18 million.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are over $30 billion in asbestos trust funds to compensate victims of mesothelioma and other asbestos-related diseases.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are more than 50 bankruptcy trusts accepting claims to compensate victims of mesothelioma and other asbestos-related diseases.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are many “asbestos dockets” that permit living mesothelioma patients to obtain a jury verdict in less than 1 year.
  • Mesothelioma Facts
    Mesothelioma Facts
    In 2015, more than 2000 mesothelioma cases were filed in the United States.
  • Mesothelioma Facts
    Mesothelioma Facts
    In some mesothelioma cases, settlements can be obtained in less than 1 year.
  • Mesothelioma Facts
    Mesothelioma Facts
    Thousands of different companies have been defendants in mesothelioma cases over the past 40 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma cases, the average life expectancy (median survival period) was 75.7 months, or over 6 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma patients, 73.8% were living after 3 years, and 65.3% were living after 5 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 77 peritoneal mesothelioma patients, 64% were treated with HIPEC and cytoreductive surgery.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of 303 pleural mesothelioma patients, the average life expectancy (median survival period) was 18.4 months.
  • Mesothelioma Facts
    Mesothelioma Facts
    According to a 2015 study of pleural mesothelioma patients, 73.1% were still living after 1 year, and 22.9% were still living after 3 years.
  • Mesothelioma Facts
    Mesothelioma Facts
    In 2015, the largest number of mesothelioma cases were filed in the following 10 courts: (1) Madison County, IL; (2) Cook County, IL; (3) St. Louis, MO; (4) Los Angeles, CA; (5) New York, NY; (6) Philadelphia, PA; (7) New Castle County, DE; (8) Middlesex County, MA; (9)Middlesex County, NJ; (10) Kanawha County, WV.
  • Mesothelioma Facts
    Mesothelioma Facts
    The states with the largest number of diagnosed mesothelioma cases are: New York, New Jersey, California, Washington, Pennsylvania, Massachusetts, Virginia, Florida, Texas, Illinois, Wisconsin, Michigan and Ohio.
  • Mesothelioma Facts
    Mesothelioma Facts
    There are about 3000 mesothelioma cases diagnosed in the United States each year.
  • Mesothelioma Facts
    Mesothelioma Facts
    About 1 in 100,000 people in the United States will be diagnosed with mesothelioma each year in the United States.
  • Mesothelioma Facts
    Mesothelioma Facts
    More than 80% of all mesothelioma cases occur in the pleura (pleural mesothelioma).
  • Mesothelioma Facts
    Mesothelioma Facts
    Less than 20% of all mesothelioma cases occur in the peritoneum (peritoneal mesothelioma).
  • Mesothelioma Facts
    Mesothelioma Facts
    About 22% of all mesothelioma cases occur in women.
  • Mesothelioma Facts
    Mesothelioma Facts
    A history of asbestos exposure can be found in more than 80% of mesothelioma cases.
  • Mesothelioma Facts
    Mesothelioma Facts
    More than 30% of all mesothelioma patients in the United States were exposed to asbestos in the military.
  • Mesothelioma Facts
    Mesothelioma Facts
    Mesothelioma can be caused by laundering, or other household contact with, work clothing contaminated with asbestos.
  • Mesothelioma Facts
    Mesothelioma Facts
    Mesothelioma can be caused by work with (direct exposure) or around (bystander exposure) asbestos-containing products.
  • Mesothelioma Facts
    Mesothelioma Facts
    The average time between a person’s first exposure to asbestos and the development of mesothelioma (latency period) is more than 40 years.
 

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