Surgery for peritoneal mesothelioma

A small number of people with peritoneal mesothelioma may be offered surgery. This is called complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Whether this treatment is suitable for you depends on many different things. These include:

the type of mesothelioma
the location of the mesothelioma in the tummy area
if the surgeon thinks it is possible to completely remove the mesothelioma
your general fitness.

The operation will be done by a surgeon who is experienced in treating peritoneal mesothelioma. You will need to travel to a specialist centre for this surgery. If your specialist offers you surgery, they will give you more information about what to expect.

Related pages

Preparing for surgery

Surgery to remove the peritoneum (peritonectomy)

The surgeon will remove most of your peritoneum. This is called a peritonectomy. They may also have to remove affected nearby organs. These may include the spleen, the gallbladder, and sometimes part of the bowel. You may also need to have the womb and ovaries removed. People who have a womb and ovaries include women, transgender (trans) men and people assigned female at birth.

If you need part of the bowel removed, you may need to have a bag fitted on your tummy to collect your stools (poo). This is called a stoma. The stoma may be temporary or permanent, depending on the situation.

During the surgery, the surgeon will remove as much of the tumours as they can see. Then they will put a heated chemotherapy drug directly into your tummy. This is called hyperthermic intraperitoneal chemotherapy (HIPEC).

Chemotherapy into the abdomen (HIPEC)

If you are having surgery for peritoneal mesothelioma, your doctor may suggest having chemotherapy into the tummy (abdomen) during the surgery. This is called HIPEC (hyperthermic intraperitoneal chemotherapy).

This treatment is usually only suitable for a small number of people.

During the operation, the surgeon removes all, or most, of the tumours they can see. They then wash out the area to try to remove any loose mesothelioma cells, and put chemotherapy into the tummy (abdomen).

The chemotherapy drugs used are usually doxorubicin and cisplatin. The chemotherapy is gently heated before being put in your tummy. This can help it work better for this type of cancer.

The side effects of giving chemotherapy this way can be different to giving chemotherapy into a vein. Your doctor or nurse will explain what to expect.

Related pages

References

Below is a sample of the sources used in our mesothelioma cancer information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk

Kusamura S, Kepenekian V, Villeneuve L, Lurvink RJ, Govaerts K, De Hingh IHJT, Moran BJ, Van der Speeten K, Deraco M, Glehen O; PSOGI. Peritoneal mesothelioma: PSOGI/EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Eur J Surg Oncol. 2021 Vol, 47(1) pp6-59. [accessed April 2024].

Popat, S., Baas P., Faivre-Finn, C., Girard, N., Nicholson, A., Nowak, A., Opitz, I., Scherpereel, A, and Reck, M. 2021. ESMO Pleural mesothelioma guidelines. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Available from: https://www.annalsofoncology.org/action/showPdf [accessed April 2024].

Cancer Information Development team

Author

Dr David Gilligan

Reviewer

Consultant Clinical Oncologist

Addenbrookes Hospital, Cambridge

Date reviewed

Reviewed: 01 February 2025

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Next review: 01 February 2028

The language we use

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We want our information to be as clear as possible. To do this, we try to:

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