Intraperitoneal chemotherapy (HIPEC)

After cytoreductive surgery, in which the surgeon removes all visible tumour deposits, a chemotherapy solution — for example cisplatin — heated to about 41–43°C is circulated through the abdominal cavity for 30 to 120 minutes; the drug chosen depends on the cancer type. Direct administration produces far higher drug concentrations at the peritoneal surface than an intravenous infusion, while the peritoneal barrier limits how much drug enters the bloodstream and causes body-wide effects. The heat itself damages cancer cells, increases how deeply the drug penetrates tissue, and enhances the action of drugs such as cisplatin. Because the drug penetrates only a few millimetres into tissue, HIPEC targets microscopic residual disease — which is why removing all visible tumour first is a precondition. Professional guidelines differ on where HIPEC belongs in treatment, and protocols (drug choice, perfusion time, patient selection) are still being standardized, so outside ovarian cancer the method is largely evaluated within clinical trials.