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What is CRS and HIPEC?
Cytoreductive Surgery (CRS) involves surgically removing all visible cancer from the abdomen. HIPEC (Hyperthermic Intraperitoneal Chemotherapy) delivers heated chemotherapy directly into the abdomen during surgery to kill remaining microscopic cancer cells. The heat (41–42°C) enhances the chemotherapy’s effect, targeting cancer cells more effectively without harming the body’s blood system. This approach is more effective than systemic (IV) chemotherapy for some patients because it delivers a higher dose of chemotherapy directly to the cancer site, reducing side effects like blood toxicity.
What is Peritoneal Carcinomatosis?
Peritoneal carcinomatosis is a condition where cancer spreads to the lining of the abdomen (peritoneum). It is commonly seen in: Pseudomyxoma Peritonei – A build-up of mucus in the peritoneal cavity Colorectal cancer : Cancer from colon or rectum Appendix cancer: A type of cancer that begins in cells that line the appendix and produces mucin Ovarian cancer : Cancer that forms in the tissue of the ovary Stomach cancer : Cancer in gastric mucosa lining stomach.
How is CRS and HIPEC Performed?
Surgery (CRS): Surgeons open the abdomen to remove all visible cancer from the peritoneum and affected organs (e.g., parts of the intestine,uterus, ovary, peritoneum, stomach, or colon). The goal is to leave no visible cancer (complete cytoreduction, CC-0) or only tiny tumors less than 2.5 mm (CC-1). HIPEC: After surgery, a heated chemotherapy solution is circulated in the abdomen for about 90 minutes using a specialized machine in the operation theatre at the time of surgery. Early Postoperative Chemotherapy (EPIC): For some patients, chemotherapy is given through abdominal drains for 5 days after surgery to target any remaining cancer cells.
Benefits of CRS and HIPEC
Improved Survival: Studies show CRS and HIPEC can significantly extend survival compared to systemic chemotherapy alone. For example, patients with appendix cancer treated with this technique have shown survival rates of up to 16 years. Better Outcomes for Early Disease: Patients with less advanced peritoneal disease benefit the most. Complete removal of visible cancer (CC-0 or CC-1) leads to the best results. Hope for Advanced Cases: Even in cases with some remaining small tumors (CC-2), this treatment may still offer benefits.
Who Can Benefit?
Following patient can benifit from this treatment: Peritoneal carcinomatosis from colorectal, appendix, or stomach cancer. No cancer spread outside the abdomen. Good overall health. Low Peritoneal Carcinomatosis Index (PCI) score (less than 20). Good response to prior chemotherapy. Not suitable for: Patients with poor health. Cancer spread beyond the abdomen. Extensive or bulky peritoneal disease requiring major bowel removal.
