Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a highly specialized treatment considered for selected patients with peritoneal metastases. The operation aims to remove visible tumor in the abdomen, followed by heated chemotherapy delivered directly into the abdominal cavity. Eligibility depends on the primary tumor, extent of peritoneal disease, disease outside the abdomen, resectability, overall fitness and multidisciplinary review.
HIPEC is only one part of a major surgical pathway
At Charité, the treatment concept combines cytoreductive surgery with HIPEC. The operation may require removal of involved portions of bowel, stomach or other structures if complete or near-complete tumor removal is considered feasible.
Selection is critical
Charité emphasizes that CRS + HIPEC should be considered individually. The approach is generally most relevant when macroscopic tumor in the abdomen can be removed and when disease outside the abdominal cavity does not make the local-regional procedure inappropriate.
- Primary tumor type
- Peritoneal disease extent
- Presence of extra-abdominal metastases
- Whether complete cytoreduction appears feasible
- Prior abdominal operations
- Current systemic treatment
- Heart, lung and general functional status
A tumor board should review the case before travel
The center requests operative reports, pathology, systemic-therapy history and radiology, including the actual imaging where possible. Complex cases should be discussed in an interdisciplinary tumor conference before a treatment recommendation is assumed.
Sometimes the final decision is made during surgery
Even after preoperative imaging, the true extent of peritoneal disease may only become clear at laparoscopy or laparotomy. Charité notes that an operation may be stopped without CRS/HIPEC if safe and meaningful tumor reduction is not achievable.
Plan recovery and follow-up, not only the operation
CRS + HIPEC can involve a major abdominal operation, inpatient recovery and follow-up. International patients should clarify expected hospital stay, complication management, pathology review, systemic-treatment planning and which follow-up can safely continue at home.
Sources and review
This guide was last source-reviewed on 2026-08-29.