Regional Perfusion Therapy for Peritoneal Metastases

Peritoneal metastases occur when cancer spreads from an internal organ to the lining of the abdominal cavity.

Cancer often spreads to the abdominal cavity from the following organs:

• Appendix
• Colon and rectum
• Fallopian tubes
• Ovaries

Doctors may be able to treat peritoneal metastases with specialized surgical techniques and regional therapies.

Hyperthermic Intraperitoneal Chemoperfusion (HIPEC) for Peritoneal Metastases

HIPEC is a type of advanced regional perfusion cancer therapy surgeons may use to treat peritoneal metastases. It involves receiving very high doses of heated chemo directly into the abdomen.

Standard chemo, which circulates throughout the entire body, has little effect against peritoneal metastases.

Regional perfusion therapies — like HIPEC — are cutting-edge surgical techniques we offer at UPMC that have proven more successful in some people. The benefit of this treatment is that it effectively kills cancer while limiting harm to the rest of the body.

When combined with cytoreductive surgery (CRS) - or debulking surgery — HIPEC may significantly increase life span.

CRS-HIPEC is a complex treatment that requires a highly skilled team of experts. Since 2001, our program at UPMC Hillman Cancer Center has done more than 1,900 CRS-HIPEC procedures.

Your doctor may suggest CRS-HIPEC, based on your diagnosis and health.

What to Expect During Treatment for Peritoneal Metastases

In most cases, your surgeon will combine HIPEC with CRS.

You will sleep through the treatment under general anesthesia.

You'll have CRS first to remove as much of the tumor as possible. Right after, you'll have HIPEC to treat any leftover small or unseen microscopic nodules.

During HIPEC, your surgeon:

• Inserts small tubes and temperature probes into your stomach. One tube carries the heated chemo solution to your abdomen. The other tube circulates the fluid back to a heating element. This keeps the chemo between 105 and 107.6 F (40.6 to 42 C) in the belly.
• Will rock you back and forth for about two hours to make sure the chemo drug washes over all the cancer cells. This process aims to kill any remaining cancer within the abdomen.

After CRS-HIPEC, your surgeon:

• Turns off the pump to let your body return to a normal temperature.
• Flushes the stomach with a saline solution to clear out the chemo medicine.
• Removes the tubes and probes, and closes the incisions.

CRS-HIPEC surgery can last a long time, depending on how many tumors you have.

Prognosis for Peritoneal Metastases

By the time your cancer spreads to the lining of your abdomen, it's quite advanced. Your outlook with peritoneal metastases depends on your original type of cancer.

CRS-HIPEC can offer some people with peritoneal metastases a much better outlook than traditional chemo alone.