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Local therapy
Cytoreductive surgery & HIPEC
Extensive surgery followed by heated chemotherapy washed through the abdomen.
Referral & opinion only
What it is
Where cancer has spread across the lining of the abdomen, cytoreductive surgery removes all visible disease and HIPEC circulates heated chemotherapy through the abdominal cavity at the end of the operation.
It is a long operation with a significant recovery, done only at centres that perform it regularly. Patient selection is the whole of it, this is not an operation to have somewhere that does two a year.
When it is used
- Selected peritoneal disease from ovarian, colorectal, appendiceal or gastric primaries
- Where the disease burden is judged completely removable
- In a patient fit enough for a long operation and a long recovery
How the decision is made
- Disease burden scoring on imaging and often at laparoscopy, whether complete cytoreduction is realistically achievable.
- Fitness, honestly assessed. Recovery is measured in months.
- Centre volume. Ask how many they do a year, and accept a referral onward if the answer is small.
At a high-volume peritoneal surface malignancy centre, with prolonged admission and intensive care.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Candidacy assessment and imaging review at the board
- Referral to a centre that performs these regularly
- Nutrition optimisation before surgery, this materially affects recovery
- Stoma counselling where relevant
- Cost and scheme mapping
- Follow-up and surveillance afterwards
Performed and billed elsewhere
- The operation and HIPEC
- Intensive care and admission
- All inpatient management
- Ask directly how many of these operations the centre performs each year. Volume is one of the few things that is reliably associated with how these operations go.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Is complete removal of visible disease realistically achievable?
- How many of these does the centre do a year?
- What is the recovery, honestly, in months?
- What is the alternative if we do not do this?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.