Mesothelioma Treatment: Understanding Cytoreductive Surgery and HIPEC

Mesothelioma Treatment: Understanding Cytoreductive Surgery and HIPEC

Peritoneal mesothelioma is a rare cancer linked to asbestos exposure. It’s aggressive. However, a promising option combines cytoreductive surgery (CRS) with hot chemotherapy (HIPEC).

A new article explains the CRS and HIPEC procedures and details their role in mesothelioma treatment.

What is Cytoreductive Surgery (CRS)?

Cytoreductive surgery removes as much tumor as possible. For peritoneal mesothelioma, it targets visible cancer in the abdomen, including organs like the intestines, liver, and spleen.

Extensive surgery is crucial. It often involves removing multiple organs to eradicate all cancer cells. This aims to reduce the tumor to a microscopic level, making treatments more effective.

Patient selection is vital. Only those with good health and a disease extent that can handle major surgery are considered.

What is Hyperthermic Intraperitoneal Chemotherapy (HIPEC)?

After cytoreductive surgery, the next step is HIPEC. This procedure directly applies heated chemotherapy to the abdomen.

HIPEC combines heat and chemotherapy. The solution is heated to 41-43°C (105.8-109.4°F). This temperature kills cancer cells and boosts drug effectiveness.

Direct application is crucial. Unlike systemic chemotherapy, HIPEC targets the area directly, reducing overall toxicity. The procedure lasts 60-90 minutes. It is done during surgery.

Benefits of CRS and HIPEC

CRS boosts survival. Combining it with HIPEC enhances survival rates in peritoneal mesothelioma patients. Next, it offers localized treatment. By applying chemo directly, doses can be higher with fewer side effects.

It also lowers recurrence. This method aims to prevent cancer from coming back. It targets tiny remaining diseases.

Minimally Invasive Approaches to CRS and HIPEC

Typically, CRS and HIPEC surgeries are highly invasive, with large incisions and organ removal. Now, some centers are adopting minimally invasive methods. This aims to lower patient complications and speed up recovery.

These surgeries use smaller incisions. They might reduce recovery time and post-surgery issues. These methods are mainly for patients with a low Peritoneal Cancer Index (PCI) score. This score shows less disease.

Studies show that minimally invasive techniques are safe and effective. They’re comparable to open surgery for some patients. Their short-term recurrence rates and overall survival are similar.

Surgery and heated chemotherapy are key treatments for peritoneal mesothelioma. They boost survival and life quality. Using less invasive methods makes it safer, especially for the right patients. Ongoing studies will improve patient selection and treatment. This aims for better outcomes.

Knowing about these treatments is vital for patients and families. It helps them make informed choices and manage mesothelioma care.


Cohen, Lauren, Faizah Alam, Michael P. Flood, Helen Mohan, Anshini Jain, Glen Guerra, Alexander G. Heriot, and Joseph C. H. Kong. “A Systematic Review of Minimally Invasive Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Patients with Peritoneal Malignancy.” ANZ Journal of Surgery, May 15, 2024.

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