Advancements in Treating Peritoneal Malignancies: Cytoreductive Surgery & HIPEC By Dr Srikanth Reddy

Peritoneal malignancies are a severe form of cancer where tumors from abdominal organs spread across the peritoneal (abdominal) cavity. Traditionally, patients diagnosed with such conditions had limited treatment options, with survival rates ranging between six months to a year. However, advancements in surgical techniques and chemotherapy have opened doors for potential cures, offering hope to patients.

In this blog, we discuss Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)—a breakthrough treatment for peritoneal malignancies, with insights from Dr. Bharat, Dr. Srikanth Reddy, and Dr. Sandeep Nayak, leading experts in surgical oncology.

Understanding Peritoneal Malignancies

Peritoneal malignancies occur when cancer originating in organs like the ovaries, intestines, liver, or appendix spreads across the peritoneal surface—a thin membrane lining the abdominal cavity. This widespread dissemination makes conventional treatments like systemic chemotherapy less effective.

However, with the advent of HIPEC and Cytoreductive Surgery, oncologists now have a method to aggressively remove visible tumors and target microscopic cancer cells directly in the abdomen.

What is HIPEC?

Hyperthermic Intraperitoneal Chemotherapy (HIPEC) is a specialized cancer treatment that follows Cytoreductive Surgery (CRS). It involves circulating heated chemotherapy drugs within the abdominal cavity to destroy remaining cancer cells.

Key Steps in HIPEC:

Cytoreductive Surgery (CRS):

• The first step is to surgically remove all visible cancerous tissue in the abdominal cavity.
• This may involve removing affected organs like the ovaries, intestines, peritoneal lining, appendix, gallbladder, or even the outer layer of the liver if necessary.
• The goal is to eliminate macroscopic (visible) tumor deposits to enhance the effectiveness of chemotherapy.

HIPEC Treatment:

• After CRS, chemotherapy drugs are heated and circulated within the abdominal cavity for 60 to 90 minutes using a specialized machine.
• The heated chemotherapy helps penetrate deeper into cancerous tissues, increasing effectiveness while minimizing side effects compared to traditional chemotherapy.

How Does HIPEC Help?

• Targets Remaining Cancer Cells: Unlike systemic chemotherapy, HIPEC directly acts on microscopic cancer cells left after surgery.
• Increases Drug Absorption: The heated chemotherapy enhances drug penetration, making it more effective.
• Minimizes Side Effects: Since chemotherapy is not circulated throughout the entire body, systemic toxicity is reduced.

Improves Survival Rates: Patients who undergo CRS + HIPEC have significantly improved survival outcomes compared to those receiving traditional chemotherapy.

Who Can Benefit from HIPEC?

HIPEC is primarily used for patients with advanced peritoneal malignancies, including:

• Ovarian Cancer

• Colorectal Cancer

• Appendiceal Cancer

• Peritoneal Mesothelioma

• Gastric Cancer with Peritoneal Spread

Not all patients are candidates for HIPEC, and a thorough evaluation by an oncology team is essential to determine eligibility.

Conclusion

The combination of Cytoreductive Surgery (CRS) and HIPEC has revolutionized the treatment of peritoneal malignancies, offering improved survival rates and, in some cases, the possibility of a cure. This advanced technique is now a beacon of hope for patients diagnosed with abdominal cancers that were once considered untreatable.

If you or a loved one has been diagnosed with peritoneal malignancies, consult with an oncology specialist to explore the best treatment options.