Cytoreduction with hyperthermic intraperitoneal chemotherapy (HIPEC) is a challenging procedure, one which usually takes hours to complete.

The treatment is the best method for many peritoneal mesothelioma patients to prolong their lives and rid their bodies of mesothelioma.

Cytoreduction with HIPEC is also linked to an improved quality of life, including decreased depression.

Wake Forest University and Wake Forest Baptist Cancer Center researchers found this result in the 46 people analyzed in a recent study. The patients all underwent cytoreduction with HIPEC and had a median survival of 40 months (3.4 years).

More than half of the patients survived for at least three years after the operation, and around 30% lived for at least five years. The one-year survival in the study was 77.4%.

This treatment is often associated with lengthy survival times. However, the operation can be intimidating at first glance.


What Cytoreduction With HIPEC Entails

Peritoneal mesothelioma forms in the peritoneum, which is a thin membrane covering the abdominal cavity. The cancer is comprised of microscopic tumors that can spread into the cavity, affecting nearby organs such as the intestines, liver, gallbladder, spleen, pancreas and kidneys.

Cytoreduction with HIPEC aims to remove these tumors and protect the organs in the abdominal cavity. The cytoreduction phase involves removing the peritoneum along with these tumors. Doing so reduces as much “bulk” as possible, which precedes the HIPEC portion of the treatment.

HIPEC is a heated chemotherapy bath in the abdominal cavity. This liquid chemotherapy attacks the remaining cancer cells not removed during cytoreduction. The entire operation can take several hours, and recovery (combining in the hospital and at home) could take up to two months. The lengthy rehabilitation is due to the abdominal cavity being comprised so many organs.

Despite this lengthy recovery time, there is evidence showing the long-term benefits.


Measuring Quality of Life Following Cytoreduction With HIPEC

Many mesothelioma-involved studies focus on survival times, but studying the mental health of mesothelioma patients is also essential.

Researchers used the Center for Epidemiologic Studies Depression Scale (CES-D) to help determine the patients’ quality of life following surgery. CES-D is a screening test for depression and depressive disorder. It measures symptoms defined by the American Psychiatric Association’s Diagnostic and Statistical Manual.

Researchers reported that the patients’ CES-D score worsened in the three months following surgery but then improved at the 24-month mark. They also found that:

  • Patients’ physical functioning initially worsened but then returned to normal after at the one-year mark
  • General health decreased at first but then improved at six months following surgery
  • Emotional well-being, social functioning, and physical pain scoring all improved

“Quality of life returned to baseline or improved from baseline between three months and one year following surgery,” the researchers wrote in their report. “Despite the risks associated with this operation, patients may tolerate HIPEC well and have good overall quality of life postoperatively.”

Before choosing a mesothelioma treatment for your diagnosis, understand what each entails. Knowing the benefits and risks of each will help you make an informed decision on how to attack this disease.

You should also prioritize finding a mesothelioma specialist who can guide you to the appropriate treatment. You may be a candidate for cytoreduction with HIPEC, or you may be better suited for a clinical trial or other forms of care. Our patient advocate, Karen Ritter, can help you connect with an experienced mesothelioma doctor. Email her at to discuss further your options as a patient.

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    Sources & Author

  1. Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma. Annals of Surgical Oncology. Retrieved from: Accessed: 12/02/19.
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About the Writer, Devin Golden

Devin Golden is the content writer for Mesothelioma Guide. He produces mesothelioma-related content on various mediums, including the Mesothelioma Guide website and social media channels. Devin's objective is to translate complex information regarding mesothelioma into informative, easily absorbable content to help patients and their loved ones.