Hemmer PHJ, Van Leeuwen BL. Hyperthermic intraperitoneal chemotherapy (HIPEC). Huisarts Wet 2013;56(1):36-9.Surgery forms the basis of cancer therapy, and surgical resection sometimes improves survival in metastatic disease. One such surgical approach is cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). In this procedure, the surgeon removes all visible tumour from the abdominal cavity and then flushes the cavity with a warmed solution of chemotherapy agents. Once the patient has recovered, adjunct chemotherapy is started. The technique was introduced in the 1990s for the treatment of pseudomyxoma peritonei but is now also used for peritoneal carcinomatosis and malignant peritoneal mesothelioma. Six centres in the Netherlands provide HIPEC.It is an aggressive and taxing, but effective, procedure. Patients with peritoneal metastases from colon cancer usually have a poor prognosis, but after HIPEC the 5-year survival rate is 30% and even 50% in certain patient groups. Procedure mortality is 4% but is decreasing. Throughout treatment, considerable attention should be paid to managing the physical and mental health of the patient, and in this the general practitioner has an essential role in detecting treatment-related physical problems. Special attention should be paid to psychosocial problems, stoma, fever, tube feeding, splenectomy, enterocutaneous fistula, and tumour recurrence.

Surgery forms the basis of cancer therapy, and surgical resection sometimes improves survival in metastatic disease. One such surgical approach is cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). In this procedure, the surgeon removes all visible tumour from the abdominal cavity and then flushes the cavity with a warmed solution of chemotherapy agents. Once the patient has recovered, adjunct chemotherapy is started. The technique was introduced in the 1990s for the treatment of pseudomyxoma peritonei but is now also used for peritoneal carcinomatosis and malignant peritoneal mesothelioma. Six centres in the Netherlands provide HIPEC. It is an aggressive and taxing, but effective, procedure. Patients with peritoneal metastases from colon cancer usually have a poor prognosis, but after HIPEC the 5-year survival rate is 30% and even 50% in certain patient groups. Procedure mortality is 4% but is decreasing. Throughout treatment, considerable attention should be paid to managing the physical and mental health of the patient, and in this the general practitioner has an essential role in detecting treatment-related physical problems. Special attention should be paid to psychosocial problems, stoma, fever, tube feeding, splenectomy, enterocutaneous fistula, and tumour recurrence.