Essential Questions to ask if you or a loved one has been diagnosed with Mesothelioma ***IMPORTANT***

Who are Eligible for Cytoreduction/HIPEC for Peritoneal Mesothelioma?

Posted on: October 14, 2023 *Updated on: May 27, 2024

Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a complex procedure that has shown promising results for patients with peritoneal mesothelioma. However, not all patients are ideal candidates for this procedure. Eligibility is based on various factors that can determine the potential benefits and risks of undergoing such a treatment.

Let’s summarize the factors affecting eligibility for cytoreduction with HIPEC:

  1. Peritoneal Cancer Index (PCI) Score:
    • This score indicates the extent to which the cancer has spread within the abdominal cavity.
    • A high PCI score (e.g., scores above 20) often suggests the disease has spread too widely for surgery to provide substantial benefits.
  2. Physical Health:
    • The procedure is invasive, so a patient’s overall health is paramount.
    • The patient must be fit enough to handle the surgery itself, as well as the anesthesia, post-operative recovery, and associated pain.
    • Those with serious concurrent health issues might be considered at too high a risk for the procedure.
  3. Age:
    • While age alone isn’t a strict criterion, younger patients often have better physical health, making them more suitable candidates.
    • However, some older patients, depending on their health status, may still be eligible.
  4. Cell Type of Mesothelioma:
    • Epithelioid cells: These are the most common cell type and are relatively easier to treat. They are more identifiable and removable compared to other cell types.
    • Sarcomatoid cells: These cells are harder to treat as they are challenging to identify and remove. They also tend to grow faster.
    • Biphasic mesothelioma: This is a combination of epithelioid and sarcomatoid cells. Some surgeons might consider surgery if the majority of the cells are epithelioid.

For patients considering cytoreductive surgery with HIPEC, it’s essential to consult with a mesothelioma specialist who can provide a thorough evaluation. They can give a clearer understanding of the potential benefits and risks based on the individual’s specific circumstances. As medical advancements continue, criteria and protocols for treatments may evolve, so staying informed and in regular contact with healthcare providers is crucial.