HIPEC Procedure Extends Survival for Patients With Advanced Abdominal Cancers
Patients battling aggressive abdominal cancers—including colorectal, appendix, and peritoneal mesothelioma—are living significantly longer after undergoing a specialized treatment called hyperthermic intraperitoneal chemotherapy (HIPEC), according to recent clinical findings. The procedure, which combines surgical tumor removal with heated chemotherapy delivered directly to the abdomen, has emerged as a promising option for cases once considered difficult to treat.
Researchers at Cipto Mangunkusumo Hospital in Jakarta reported that patients who received HIPEC alongside cytoreductive surgery (CRS) experienced a median overall survival of 41 months. In comparison, those who underwent CRS alone had a median survival of 16 months—a difference experts describe as clinically meaningful for a population with historically limited treatment options.
“This is not a cure, but it offers patients more time and, in some cases, the chance to return to their daily lives,” said Dr. Adianto Nugroho, an oncologist and lead investigator of the study. The findings, presented at the 2026 Asia-Pacific Oncology Symposium, underscore the procedure’s potential to shift the treatment paradigm for cancers that have spread within the abdominal cavity.
How HIPEC Works
HIPEC is a two-part procedure performed under general anesthesia. First, surgeons remove visible tumors from the abdominal lining and organs during CRS. Then, a heated chemotherapy solution—typically warmed to 106–109°F—is circulated throughout the abdominal cavity for 30 to 120 minutes. The heat enhances the drugs’ ability to penetrate cancer cells while sparing healthy tissue, as cancer cells are more vulnerable to thermal damage.
The approach is particularly effective for cancers that originate in or metastasize to the peritoneum, the thin membrane lining the abdomen. These include:
- Colorectal cancer with peritoneal spread
- Appendiceal cancer
- Peritoneal mesothelioma (often linked to asbestos exposure)
- Advanced ovarian and gastric cancers
Unlike traditional intravenous chemotherapy, which travels through the bloodstream and can cause systemic side effects, HIPEC delivers high concentrations of drugs directly to the affected area. This localized approach reduces toxicity while maximizing the treatment’s impact on residual cancer cells.
Recovery and Considerations
HIPEC is a complex procedure, typically requiring 8 to 10 hours in the operating room and a hospital stay of 10 to 14 days. Patients often spend the first 24 to 48 hours in intensive care as their bodies recover from the dual trauma of surgery and heated chemotherapy. Common side effects include fatigue, nausea, and temporary digestive issues, though these are generally less severe than those associated with systemic chemotherapy.
Not all patients are candidates for HIPEC. Eligibility depends on factors such as the cancer’s stage, the extent of peritoneal spread, and the patient’s overall health. “We carefully evaluate each case to ensure the benefits outweigh the risks,” Dr. Nugroho noted. “For those who qualify, HIPEC can be a game-changer.”
Growing Evidence, Global Adoption
The procedure, first developed in the 1980s, has gained traction in recent years as studies continue to demonstrate its efficacy. While long-term data are still emerging, early results have prompted hospitals worldwide to establish HIPEC programs. In Indonesia, Cipto Mangunkusumo Hospital has become a regional leader in the technique, performing over 150 procedures since 2020.
For patients like 52-year-old Jakarta resident Rini Susanti, who was diagnosed with peritoneal mesothelioma in 2024, HIPEC offered a lifeline. “I was told my options were limited,” she recalled. “After the surgery, I had months where I could barely get out of bed. But now, two years later, I’m back at operate and spending time with my family. It’s not perfect, but it’s more than I hoped for.”
While HIPEC is not a universal solution, its ability to extend survival and improve quality of life for patients with advanced abdominal cancers has made it a valuable tool in oncology. As research continues, experts hope to refine patient selection criteria and optimize drug combinations to further enhance outcomes.
The findings arrive at a critical time, as global cancer rates continue to rise. Abdominal cancers, in particular, are often diagnosed at advanced stages, leaving patients with few effective treatment options. Procedures like HIPEC highlight the importance of specialized therapies in addressing the unique challenges of metastatic disease.
“HIPEC represents a significant advancement in how we approach cancers that have spread within the abdomen. While it’s not suitable for everyone, the survival benefits we’re seeing are encouraging and warrant further study.”
— Dr. Adianto Nugroho, Oncologist, Cipto Mangunkusumo Hospital
For more information on HIPEC and its applications, visit the National Cancer Institute’s fact sheet or consult with an oncologist specializing in peritoneal surface malignancies.
