Dr. Pandalai on the Use of Cytoreductive Surgery Plus HIPEC in Colorectal Peritoneal Carcinomatosis

Prakash Pandalai, MD, ​assistant professor of surgery, surgical oncologist, University of Kentucky, Markey Cancer Center, discusses the use of cytoreductive surgery plus heated intraperitoneal chemotherapy (HIPEC) in the treatment of patients with colorectal peritoneal carcinomatosis.

Cytoreductive surgery and HIPEC are often thought of as a combination operation, but it's actually 2 separate procedures, according to Pandalai. The goal of cytoreductive surgery is to remove all the gross visible tumors, resulting in a multi-visceral resection during which a small piece of the intestine, colon, or appendix can be removed if they are found to have tumor deposits.

After surgery is complete, it's important to understand that the abdominal cavity can contain additional cancer cells following cytoreductive surgery, Pandalai explains. As such, catheters can be placed inside the abdominal cavity, allowing it to be profused for a period of time with chemotherapy that is infused in a heated solution.

Investigators set out to determine the value of each component of this regimen through the PRODIGE 7 study, during which patients were randomized to receive cytoreductive surgery with or without HIPEC. Through this approach, investigators were able to assess the efficacy of HIPEC, Pandalai concludes.