What is HITHOC?

Radical Pleurectomy with or without adjacent organ resection with Hyperthermic Intra Thoracic Chemotherapy is usually done in adults with primary pleural malignancies like mesothelioma and secondary pleural tumours due to thymoma.

After the surgery is completed the patient is subjected to 90 mins of intraoperative chemotherapy at 42 degrees centigrade which helps us to kill all the microscopic cancer cells and has good locoregional control.

Indications

Primary pleural tumours and secondary pleural tumours

Is it common in children? If so, why?

HITHOC is never done in adolescence.

The reason why we did this technology for this adolescent is because of the experience that we gained with adult patients. it was explained in detail to the patient and family members about the radicality of the procedure and its outcome, which can give us satisfactory locoregional control.

How common is it in India and what is the cause?

This procedure is not done in many centres in India, and even in adolescents, it is not reported elsewhere. this is the first case study of a HITHOC procedure in an adolescent group which proved to be effective in this particular patient, for this particular malignancy.

What are the challenges in HITHOC?

The challenge is that morbidity and mortality (ie death), are very high. but in our patient post-operative recovery was smooth and uneventful was then discharged within 2 weeks.

Outcome

Because no treatment was offered elsewhere, and no other treatment options have left this procedure proved in to be a curative procedure in this particular patient for a disease-free period of 1 year.

How was this procedure managed successfully?

He was monitored intensively in ICU, for a week where there is a high chance of morbidities like infection bleeding arrhythmia, electrolyte disturbances, renal dysfunction and pneumonia.

How was the patient post-surgery?

The patient is doing well, going to school without any difficulties for the past 1 year.