colon cancer (large intestine cancer)
The doctor will carefully assess each patient if a HIPEC is indicated or not. This evaluation is done both before and during the operation.
1. before surgery
-age: the patient can not be too old. An age below 70 year is a criterion. Younger the patient is, the greater the tolerance for intervention. Patients who have a little more than 70 years with peritoneal cancer and a limited excellent condition can always be taken into account.
motivation: the patient must be prepared to 'fight' in order to support the intervention, which is heavy.
-chemotherapy options: it must persist opportunities to administer chemotherapy after surgery. If peritoneal cancer has become resistant to all forms of chemotherapy, a HIPEC is not a good choice.
-good general condition, absence of occlusion, absence of ascites. In patients who are not fit enough, which are or have occlusion of ascites, a HIPEC does not work and the risk of complications is significantly higher. Note that these criteria are valid for HIPEC in peritoneal cancer by colon cancer.
absence of seeding to the liver or lungs. In these cases, it is unlikely that HIPEC is better than conventional chemotherapy infusion.
2. during the operation
-extension (Sugarbaker score)
-remove any possibility of
-seeding to the liver
When the score to extend Sugarbaker is above 20, when all visible tumor can not be removed, or in case of seeding to the liver, there is very little chance of achieving a HIPEC offer a better survival the patient and the intervention will not be continued (see above).
ovarian cancer
The doctor will carefully assess each patient if a HIPEC is indicated or not. This evaluation is done both before and during the operation.
1. before surgery
-age: the patient can not be too old. An age below 70 years is a criterion. Younger the patient is, the greater the tolerance for intervention. Patients who have a little more than 70 years with peritoneal cancer and a limited excellent condition can always be taken into account.
-good condition
motivation: the patient must be prepared to 'fight' in order to support the intervention, which is heavy.
-chemotherapy options: it must persist opportunities to administer chemotherapy after surgery. If peritoneal cancer has become resistant to all forms of chemotherapy, a HIPEC is not a good choice.
absence of seeding to the liver or lungs. In these cases, it is unlikely that HIPEC is better than conventional chemotherapy infusion.
2. during the operation
-possibility to remove most of the tumor after surgery, it can not remain as homes below 1 cm
-seeding to the liver
When all visible tumor larger than 1 cm can not be removed, or in case of seeding to the liver, there is very little chance of achieving a HIPEC offers better patient survival, and response will not be continued (see above).
Other tumors
For other rare forms of peritoneal cancer, there are similar criteria.
Final consideration
All information on this page is intended to provide basic information to patients with cancer of the peritoneum. In this way, the patient can prepare questions he wants to ask the surgeon, or read the text at home after the consultation. However, the disease of each patient is unique and the medical and surgical treatment of peritoneal cancer is evolving rapidly. That is why the explanation that your doctor gives you or treatments they are offering may be slightly different from this introduction. Do not be mislead. The explanations from your doctor always prevail on the explanations contained in this document.
