How is the treatment for Pseudomyxoma Peritonei

The surgical technique used in treatment is called Maximum Cytoreduction with HIPEC – an acronym in English that stands for "Hyperthermic Intraperitoneal Chemotherapy."

The first and longest phase of the procedure involves the complete removal of all visible disease foci to the naked eye. Since the peritoneum covers almost all the abdominal organs, removing tumor foci may involve a very extensive surgery, operating on virtually all organs.

Only the affected regions of the peritoneum are operated on. Healthy regions are left intact. This is a surgery that must be as conservative as possible. The surgeon makes every effort to preserve most of the organs.

At the end of this phase of the surgery, the surgeon needs to look at the abdomen and find no visible disease foci. In special situations, small foci of 1-2 millimeters may be left, which will be treated with hyperthermic chemotherapy.

Hyperthermic intraperitoneal chemotherapy is a high-concentration chemotherapy application, heated to a temperature between 41 and 43 degrees Celsius, depending on the protocol used.

The advantage of applying chemotherapy directly within the abdomen, rather than intravenously, is that the tumor foci that survived the Cytoreduction phase—those foci that are practically invisible to the naked eye—are placed directly in contact with the chemotherapy.

The penetration of the drug into the tumor is much more effective than it would be with intravenous application. The increase in temperature to 43 degrees further enhances the effect, making the chemotherapy even more toxic to the tumor.

After the completion of the Cytoreduction phase, HIPEC is applied for 30 to 90 minutes, again depending on the protocol.

Once HIPEC is finished, the surgeon concludes the surgery, closes the abdomen, and the patient is taken to the ICU.