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CRS/HIPEC Procedure Has Improved Over Time, Study Finds

CRS/HIPEC ProcedureA new French study contains some good news for people considering the CRS/HIPEC procedure for peritoneal mesothelioma. 

The CRS/HIPEC procedure combines surgical resection with localized chemotherapy. Its aim is to remove or destroy as many mesothelioma cells as possible in the abdomen. 

French researchers studied the evolution of the procedure over time. They discovered that it has improved. As a result, people with peritoneal cancers like malignant mesothelioma are living longer. 

Cytoreductive Surgery for Mesothelioma

Peritoneal mesothelioma causes tumors on the peritoneal membrane that lines the abdomen. Like other forms of mesothelioma, the cause is usually asbestos exposure. 

Cytoreductive surgery (CRS) is an operation to remove tumors from the abdomen. Mesothelioma tumors may be confined to the peritoneal membrane, or they may have spread to other abdominal organs. Surgeons try to remove all the cancer they can see. 

Unfortunately, it is nearly impossible to remove every trace of mesothelioma. The CRS/HIPEC procedure brings in chemotherapy, too. HIPEC stands for heated intraperitoneal chemotherapy. HIPEC is different from typical systemic chemotherapy. 

With HIPEC, doctors administer a heated solution of drugs directly into the abdomen. The goal of HIPEC is to kill any cancer cells left behind after surgery. If they are not removed or destroyed, these residual cells can give rise to new mesothelioma tumors. Adding HIPEC to CRS improves the odds of surviving peritoneal mesothelioma

The Evolution of the CRS/HIPEC Procedure

Mesothelioma is not the only type of cancer that can lead to tumors on the peritoneal membrane. The new French study included people with peritoneal tumors resulting from digestive or gynecological cancers, too. All of the patients had the CRS/HIPEC procedure.

The team concluded that the surgery has evolved for the better. Surgeons have learned better, safer ways to visualize and remove even the tiniest tumors. The medications, and the method for delivering them into the abdomen, have also improved. 

The result is that people are living longer after the CRS/HIPEC procedure than ever before. 

“The final objective of these evolutions is the improvement of the global and recurrence-free survival of primary and secondary malignant peritoneal pathologies,” writes study author Niki Christou in the journal Biology

But the study also cautions that “more large randomized controlled trials are needed to demonstrate the efficacy of such treatments”. The authors say future studies should take into account other variables like a patient’s genetic makeup. 

Peritoneal mesothelioma is a serious and aggressive cancer. But, thanks to evolving treatments like the CRS/HIPEC procedure, it is not always a death sentence. Some of the longest-living mesothelioma survivors are those with peritoneal disease. 

Australian Paul Kraus, who has survived mesothelioma for more than two decades, is one example. 


Christou, N, et al, “Intraperitoneal Chemotherapy for Peritoneal Metastases: Technical Innovations, Preclinical and Clinical Advances and Future Perspectives”, March 15, 2021, Biology, pp. 225, https://www.mdpi.com/2079-7737/10/3/225

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