Cleveland Clinic Florida Adds HIPEC for GI Cancers

Since introducing hyperthermic intraperitoneal chemotherapy (HIPEC) at Cleveland Clinic in 2009, the Digestive Disease Institute has performed nearly 100 procedures to date using this alternative and innovative method of delivering chemotherapy. Now, Cleveland Clinic Florida has established a HIPEC program to expand access to this potentially lifesaving procedure.

The first Florida patient was treated in February 2013 as a result of collaboration between clinicians in the Section of Surgical Oncology at Cleveland Clinic’s main campus in Ohio and colleagues at Cleveland Clinic Florida in Weston.

Sricharan Chalikonda, MD, a general surgeon who pioneered use of HIPEC at Cleveland Clinic main campus, is working closely with Conrad Simpfendorfer, MD, a hepato-pancreato-biliary and transplant surgeon at Cleveland Clinic Florida. Dr. Chalikonda is helping to establish the Florida HIPEC program and advising on the first and most complex cases.

How HIPEC works

HIPEC is a powerful tool that utilizes regional infusion of heated chemotherapy to fight cancer directly in the abdomen in combination with cytoreductive surgery, Dr. Chalikonda explains. Lower exposure to systemic chemotherapy side effects and prolonged survival (for some patients, according to early data) are among the advantages.

“The partnership with Cleveland Clinic main campus will allow patients and physicians to be confident that complex patients in Florida are going to get the exact same level of care they get at our main campus,” Dr. Chalikonda says.

Since HIPEC isn’t widely available in Florida, Dr. Simpfendorfer notes, many patients were opting to go up to Cleveland Clinic main campus, which was the first FDA-approved program in Ohio and remains one of few programs in the country offering the technology.

The extension of HIPEC to Florida was, therefore, natural – as was the collaboration between Drs. Chalikonda and Dr. Simpfendorfer, who trained together as residents.

Could HIPEC be right for your patients?

The initial Cleveland Clinic Florida patient was a man in his early 50s with a pseudomyxoma peritoneal mucinous tumor of the appendix. Its relatively slow progression gave Dr. Simpfendorfer a few months to prepare both the patient and the program. “The patient was interested only in having surgery at Cleveland Clinic. He was willing to wait two to three months. He was young and otherwise healthy – an ideal first case.”

HIPEC, however, is not for everyone. “Patient selection is critical,” Dr. Simpfendorfer says. The cancer needs to be confined to the peritoneal cavity. Patients also need to be strong enough to undergo both cytoreductive surgery and HIPEC.

Why collaboration is key

Dr. Chalikonda will continue to consult regularly with Dr. Simpfendorfer to ensure Florida patients who want Cleveland Clinic’s HIPEC expertise can get the procedure locally. Such a close collaboration also may benefit the so-called “snow birds” who split their time between Florida and Cleveland by offering a previously unavailable continuity of care.

“They can see both of us throughout the year because their care and our shared electronic medical records are seamless,” Dr. Chalikonda says.

To make a referral or for more information, please contact Dr. Chalikonda at 216.445.0053 or chaliks@ccf.org or Dr. Simpfendorfer at 954.659.5232 or simpfec1@ccf.org.