Our clinic has particular expertise in the treatment of tumors of the peritoneum. There are primary and secondary diseases of the peritoneum. Secondary diseases are metastases, mainly from malignant tumors of the gastrointestinal tract (stomach, intestine, pancreas, etc.). The aim is to achieve complete tumor removal by removing the tumor-bearing peritoneum. These complex operations are performed by a highly specialized team in a certified center. Depending on the findings, we combine the surgical procedures with modern forms of regional chemotherapy, such as HIPEC, PIPAC, or intraperitoneal chemotherapy via a port.
HIPEC – Hyperthermic Intraperitoneal Chemotherapy
HIPEC (hyperthermic intraperitoneal chemotherapy) combines cytoreductive surgery (CRS) and irrigation of the abdominal cavity with a heated chemotherapy solution (41–43°C) immediately after removal of visible tumor tissue.
Goals:
- Maximum tumor reduction
- Higher local drug concentration
- Fewer systemic side effects
- Area of application:
- For selected tumors such as stomach, colon, and appendix carcinomas, mesotheliomas, or pseudomyxoma peritonei – provided that the visible tumor could be completely removed.
- Treatment procedure:
- Usually a single therapy, inpatient stay approx. 10–14 days.
PIPAC – Pressurized Intraperitoneal Aerosol Chemotherapy
PIPAC is a minimally invasive, laparoscopic procedure in which chemotherapy is introduced into the abdominal cavity as a finely atomized aerosol under pressure. This allows for better distribution and deeper penetration of the drug into the tumor tissue.
Indication:
For patients with advanced peritoneal carcinomatosis that cannot (or can no longer) be surgically removed, usually in combination with systemic chemotherapy.
Goals:
- Symptom control
- Possible prolongation of life
- Improvement in quality of life
- Treatment procedure:
- Usually 3 cycles of therapy at intervals of approximately 6 weeks, each with a 2–3-day hospital stay.
Intra-abdominal port
In certain patients with stomach or colon cancer with peritoneal involvement, a port system can be implanted in the abdominal cavity. This allows the chemotherapy drug to be administered in a targeted manner – in addition to intravenous or oral therapy.
Advantages
- Outpatient treatment possible
- Reduction in inpatient stays
- Combination therapy to increase effectiveness
Current state of research
The phase III study DRAGON 01 (2025) showed a good response. In some cases, complete tumor removal was even possible after treatment.
Treatment procedure at our clinic
1. Preliminary diagnostics & case clarification
Using modern imaging (CT, MRI, PET if necessary) and diagnostic laparoscopy (abdominal endoscopy), we determine the so-called peritoneal carcinomatosis index (PCI) – for an accurate assessment of the tumor burden and surgical options.
2. Interdisciplinary tumor conference
Each case is discussed jointly by a tumor board consisting of experts from surgery, oncology, radiology, gastroenterology, and other fields. The aim is to arrive at an individually tailored, optimal treatment decision.
3. Individual treatment planning
The choice of treatment is based on the type of tumor, its spread, the patient's general condition, and the treatment goal – e.g. CRS & HIPEC, PIPAC for disease control, or chemotherapy via port systems as a bridge to resectability.
4. Implementation
Surgeries are performed using the latest surgical techniques—laparoscopic or robot-assisted. Our patients also benefit from highly qualified perioperative care and close monitoring.
5. Follow-up care & progress monitoring
This is followed by regular imaging checks and personal follow-up appointments to monitor the success of the treatment and detect any recurrence at an early stage.
Special consultation & second opinion
Our team will advise you on all questions during our special consultation hours. Please contact me personally, also for a second opinion!
Prof. Dr. Beate Rau,
Dr. Franziska Köhler
Special oncological surgery
Phone 0511 532 6534
Email Rau.Beate@mh-hannover.de, Koehler.Franziska2@mh-hannover.de
