Research Spotlight: Why the “Heat” in HIPEC Matters — And What It Means for Patients

Abdominal Cancers Alliance
Nov 20
2 min read

Controlling perfusion temperature relates to better outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Lopez-Ramirez, Felipe et al. European Journal of Surgical Oncology, Volume 52, Issue 1, 110536

What is HIPEC?

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) is a treatment where, after a surgeon removes as much visible tumor as possible (cytoreductive surgery), heated chemotherapy is circulated directly inside the abdominal cavity. The higher temperature helps the chemotherapy work more effectively against cancer cells.

Heated Intraperitoneal Chemotherapy Image courtesy of Mercy Hospital, Baltimore, MD

Why Temperature Management Is Important

Heating the chemotherapy gives it more “punch” — the heat can increase how strongly the drug attacks cancer and allows it to penetrate deeper into tissues.
But, if the patient’s body temperature gets too high (hyperthermia), it can lead to serious side effects.
At many centers, teams use cooling protocols during the treatment to prevent dangerous overheating.
On the other hand, overcooling (making things too cold) might reduce how effective the chemotherapy is. Too low a temperature could mean the drug is less potent.

What Research Shows About Temperature & Outcomes

One study found that patients whose abdominal cavity didn’t reach at least 38 °C by the end of the chemotherapy perfusion had worse survival outcomes.
Another study showed risk factors that make temperature spikes more likely: long perfusion times (how long the chemo bath runs), blood transfusions, and certain chemotherapy drugs.
Managing patients’ temperature is a balancing act: maintaining a “sweet spot” where the chemotherapy is effective without putting the patient at risk from overheating.

What This Means for Patients

Ask your surgical team about temperature monitoring protocols. It’s reasonable to ask how they manage body temperature during HIPEC.
Know that some level of “mild” hyperthermia (high temperature) has been linked to better outcomes, according to research — but it also comes with risk.
Choose a center with experience. Because temperature control is critical and challenging, surgeons and anesthesiologists who frequently do HIPEC are more likely to have well-established safety protocols.