Treatment for peritoneal surface malignancies

HIPEC surgery is a leading-edge therapy for patients with the complex condition called peritoneal surface malignancies. It is one of several therapies used to treat peritoneal surface malignancies.

When used for the right patients, HIPEC surgery can extend life and ease symptoms. OHSU is one of two main West Coast centers for this treatment. 

It’s important to know:

• HIPEC surgery is only for peritoneal surface malignancies. Patients with PSM have tumors inside the lining of the abdomen. Tumors can be from cancer that spread from another organ, or they can start in the lining itself.
• HIPEC requires expert care. Patients spend five to seven days in the hospital and several months in recovery.

This animation explains how HIPEC works. It depicts surgery and internal organs. Mira este video en Español. (Medical Animation Copyright © 2023 Nucleus Medical Media. All rights reserved.)

What are peritoneal surface malignancies?

The abdomen is lined with tissue called the peritoneum. It’s like a balloon that contains organs such as your stomach, liver and intestines.

Peritoneal surface malignancies are tumors that form on the inside of the peritoneum. The tumors can be from cancer that spread from another organ, such as the appendix, colon, uterus, ovaries or stomach. In patients with mesothelioma, the tumors may start in the peritoneum.

What is HIPEC surgery?

This innovative treatment has two steps:

• Cytoreductive surgery to remove tumors.
• Hyperthermic intraperitoneal chemotherapy (HIPEC) to flood your abdomen with a powerful dose of cancer-fighting drugs.

The peritoneum protects your organs and forms a barrier against infection. But it can also keep traditional chemotherapy from reaching all the cancer.

HIPEC surgery turns this problem into a solution. Instead of placing chemotherapy drugs in the bloodstream, doctors place the medications inside the peritoneum. Even better, the peritoneum stops the drugs from entering your bloodstream, reducing side effects.

Surgery

Doctors start with cytoreductive surgery to remove tumors. When possible, they use minimally invasive techniques such as robotic surgery.

This is an aggressive surgery. Doctors may remove all or parts of organs, though they spare as many organs as possible.

Chemotherapy

After the surgery, doctors use HIPEC to kill any microscopic traces of cancer. They use tubes to flood your abdomen with heated chemotherapy drugs.

This method enables doctors to deliver 20 times more chemo, with fewer side effects. The heat makes the drugs better at killing cancer cells. The solution circulates for about 90 minutes, then doctors drain it, remove the tubes and stitch you back up.

HIPEC surgery is a complex procedure. It usually requires eight to 10 hours in the operating room.

How long will I stay in the hospital?

Nationwide, many patients spend 10 to 12 days in the hospital. At the Knight, most patients spend five to seven days, thanks to our innovations. We offer extensive support before and after surgery:

• Physical therapy and a high-protein diet before surgery
• More local anesthetics, fewer narcotics
• Nutrition support
• Physical therapy after surgery

Learn more about how we support patients and their families.

Benefits

Studies show patients can have:

• Longer life span
• Fewer symptoms
• Fewer side effects, such as fatigue or hair loss

Limits

This therapy has important limitations and risks:

• Some patients may not be well enough for surgery.
• Any surgery carries a risk of complications. The risk is lower at hospitals like OHSU where HIPEC surgery is done more often.
• Patients spend days in the hospital and months recovering.

Why choose the Knight?

• Our surgeons have years of experience with HIPEC.
• We use the latest technology and techniques.
• Our innovations are shortening hospital stays and speeding recovery times.
• We're committed to excellence as a surgical quality partner of the American College of Surgeons.
• We have a HIPEC team of specialists to support you.