What peritoneal cancer means
The peritoneum is the membrane lining the abdomen. When cancer seeds it — from the appendix, colon, ovary, stomach or as primary peritoneal mesothelioma — it causes fluid build-up (ascites), bloating, and eventually bowel obstruction. Crucially, peritoneal spread often stays confined to the abdomen, which is what makes local treatment possible.
- Progressive abdominal swelling from fluid (ascites)
- Bloating, early fullness and weight loss
- Episodes of colicky pain or subacute obstruction
- Rising tumour markers or peritoneal nodules on CT
Patient selection: the Peritoneal Cancer Index
CRS-HIPEC is major surgery and helps only when disease can be completely removed. The Peritoneal Cancer Index scores disease burden at laparoscopy or imaging; combined with tumour biology and fitness, it selects the patients who benefit. Honest selection is the foundation of a good HIPEC programme.
The operation: cytoreduction plus HIPEC
First, every visible deposit is removed — peritonectomy, omentectomy and resection of involved organs, which can take many hours. Then, with the abdomen still open under anaesthesia, chemotherapy heated to 42°C is circulated through the peritoneal cavity for 60 to 90 minutes, bathing surfaces where microscopic cells may remain.
- Complete cytoreduction (CC-0) as the goal
- HIPEC at 41–43°C in the same operative sitting
- Dedicated critical care and nutrition pathway
- Programme experience spanning Christie Manchester training
Outcomes and follow-up
For pseudomyxoma peritonei and selected colorectal and ovarian peritoneal disease, CRS-HIPEC delivers survival measured in years — and in pseudomyxoma, often cure. Follow-up is lifelong, with surveillance imaging and markers on a structured calendar.
Common questions
- Is peritoneal cancer stage 4, and is it still worth treating?
- Peritoneal spread is stage IV by classification, but it behaves differently from spread to liver or lungs. For selected patients, CRS-HIPEC is a curative-intent treatment, not palliation — this distinction is exactly what a specialist assessment decides.
- Who is eligible for HIPEC?
- Patients with disease confined to the peritoneum, a PCI score low enough for complete removal, good fitness, and a tumour biology known to respond. Eligibility is decided after laparoscopy or detailed imaging review.
- Where is HIPEC available in North India?
- The peritoneal surface malignancy programme at Paras Health, Panchkula offers CRS-HIPEC for the Chandigarh Tricity and North India region.
This page is general education, reviewed by Dr. Ishaan Allahabadi, MCh Surgical Oncology (Edge Hill, UK) · MS Surgery · MBBS (Accredited by the Royal College of Surgeons of England). It is not a substitute for individual medical advice. Treatment decisions are made after reviewing your imaging and pathology, in a multidisciplinary tumour board.