Understanding New Research on Treating Peritoneal Spread of Cancer with Surgery and Heated Chemotherapy
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Framarini M, D'Acapito F, Lippolis PV, Di Giorgio A, Di Pietrantonio D, Sommariva A, Sammartino P. Expanding the role of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: A multicenter study on uncommon peritoneal malignancies. World J Clin Oncol 2025; 16(12): 112443 [PMID: 41480175 DOI: 10.5306/wjco.v16.i12.112443]
Peritoneal metastasis is when cancer cells spread from the stomach or other organs to the lining of the abdominal cavity. This type of spread can be difficult to treat and is often associated with more advanced disease and worse outcomes. Standard chemotherapy that travels through the bloodstream does not always reach these cancer cells in the abdomen effectively — which has led doctors and researchers to explore more direct approaches.
What was this study about?
This research looked at whether a treatment approach combining surgery to remove visible tumors (called cytoreductive surgery or CRS) with heated chemotherapy delivered directly into the abdomen (hyperthermic intraperitoneal chemotherapy or HIPEC) can be safe and helpful for patients whose cancer has spread inside the belly. The study included patients treated at several medical centers and gathered real-world outcomes.
What is CRS + HIPEC?
Cytoreductive Surgery (CRS): A surgical procedure to remove as much cancer as possible from the abdominal cavity.
HIPEC: After surgery, chemotherapy drugs are heated and washed throughout the abdominal cavity. Heating the chemotherapy may improve its ability to kill cancer cells and helps the drug stay in contact with microscopic disease longer than standard chemotherapy.
This approach is already used for certain cancers that spread in the abdomen, such as ovarian and colorectal cancer, and researchers are studying how well it works in other cancers, including rare or advanced cases.
Key Findings
The study reviewed outcomes from multiple hospitals and found that CRS combined with HIPEC can be performed safely in selected patients.
Some patients experienced longer survival times and better disease control, especially when cancers were carefully selected and treated aggressively with both surgery and HIPEC.
The results suggest this combined treatment may be a valuable option for patients with cancer spread inside the abdomen when traditional chemotherapy alone isn’t enough.
Why this matters
For patients with advanced gastric cancer or other cancers that have spread to the peritoneal lining, outcomes with standard chemotherapy can be poor because the drugs don’t penetrate well into abdominal tissues. Directly delivering heated chemotherapy into the abdomen right after surgery offers a way to target residual cancer cells more intensively.
This research adds to a growing body of evidence suggesting that carefully selected patients might benefit from combining surgery and HIPEC, offering hope for better outcomes in a setting where treatment options are limited.
