Surgery for Peritoneal Mets

Cytoreductive Surgery and HIPEC can prolong survival in peritoneal disease.

Hyperthermic or heated intraperitoneal chemotherapy (HIPEC) surgery is a two-step procedure that can treat certain cancers in the abdomen, including peritoneal cancer. In this procedure, cancerous tumors are surgically removed in a cytoreductive surgery, then heated chemotherapy drugs are applied directly into the abdomen to eliminate any remaining cancerous cells


Peritoneal metastases from original cancers are often managed in a similar fashion to other sites of systemic metastases, but the following must be taken into consideration. 

  • PM do not respond to systemic chemotherapy in the same fashion as liver and lung metastases.
  • PM cause local problems, resulting in disruption of chemotherapy.
  • Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) actually work for PM.
  • PM are not easily detected on imaging modalities.


There has been mounting evidence of the effectiveness of CRS-HIPEC at prolonging survival in selected patients with colorectal and gastric PM. 

Surgery, when possible, will likely be used in combination with chemotherapy, immuno-oncology, radiation, and interventional radiology procedures.  A multidisciplinary team approach is an absolute must!