Cytoreductive Surgery and HIPEC

Due to recent advances in surgical techniques, we are now able to provide more treatment options for certain late stage cancers than ever before. A technique called tumor debulking, or cytoreductive surgery (CRS), and hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to be an effective treatment option for certain patients with peritoneal surface malignancy.

This complex surgical procedure is a two-step process:

• Surgically removing any visible tumor or cancer (CRS)
• Delivering heated chemotherapy drugs into the abdomen (HIPEC)

The first phase of treatment, CRS, involves removing any visible tumors in the abdomen, which may include involved organs. The extent of surgery will be determined by the amount of tumor in your abdomen. Surgeons carefully balance the risks and benefits of organ removal with your cancer treatment and overall health, and will discuss this with you extensively prior to surgery.

During the second phase of treatment, a heated chemotherapy solution is circulated in the abdominal cavity to treat any cancer cells that may remain. The combination of heat and chemotherapy delivered directly to your abdomen in the operating room is believed to be more effective than surgery alone for certain patients with peritoneal disease because it can access and kill more cancer cells than can be found with the naked eye.

Recent studies have shown that CRS/HIPEC is beneficial for certain patients with late-stage gastrointestinal cancers and ovarian cancer. The procedure can potentially prolong life and also improve quality of life for patients. Since the chemotherapy is delivered as a one-time dose directly into the abdomen, the traditional side effects of oral or intravenous chemotherapy drugs may be avoided; however, many patients do still require intravenous chemotherapy before or after surgery.

Quality of Care

A multidisciplinary team of health care professionals will carefully review your medical records and meet with you to determine if this operation may be an effective treatment for you. Two factors are critical for successful outcomes: First, careful patient selection to determine who may benefit the most with the least amount of risk, and second, the performance of this operation at a busy national cancer center, such as The Johns Hopkins Hospital, by professionals experienced in the care of complex cancer patients.

Additional Resources