Peritoneal Carcinomatosis Unit

Highly complex oncological surgery

The unit tackles tumour spread to the peritoneum from the perspective of advanced oncological surgery, focusing on correct indication and structured planning for complex cases.

Its work is geared towards accurately determining when there is a genuine possibility of surgical treatment and how to integrate this into a coherent and safe oncological strategy.

Experience in complex peritoneal oncology

The unit treats patients with peritoneal involvement secondary to various tumours, in situations requiring expert analysis and decision-making. The aim is to determine precisely when cytoreductive treatment is indicated and to define a strategy consistent with the stage of the disease and the patient’s overall condition.

Conditions requiring expert assessment

We investigate oncological conditions involving the peritoneum that require precise surgical planning and specific knowledge of tumour biology. Key conditions include peritoneal carcinomatosis of colorectal or gastric origin, advanced or relapsed ovarian cancer, appendiceal tumours, peritoneal mesothelioma and peritoneal pseudomyxoma.

Each of these conditions presents distinct patterns of spread, its own rate of progression and a different response to therapeutic strategies. Consequently, the indication is not based solely on the presence of peritoneal disease, but on a detailed analysis of its extent, distribution and behaviour.

The feasibility of complete surgical resection and the potential clinical benefit are assessed on a case-by-case basis, integrating oncological, surgical and general patient-related criteria within a coherent therapeutic strategy.

Rigorous assessment and multidisciplinary decision-making

The assessment includes a detailed clinical examination and a thorough review of imaging studies. In selected cases, diagnostic laparoscopy may be performed to accurately determine the extent of peritoneal involvement.

Decisions are made by a multidisciplinary committee, bringing together surgical and medical oncology specialists to ensure that the treatment recommendation is well-founded and proportionate.

Cytoreductive surgery and intraperitoneal therapies

The main treatment is cytoreductive surgery, a highly complex procedure aimed at removing all visible disease from the abdominal cavity, or as much of it as possible.

These are lengthy and technically demanding procedures that may involve combined resections of different abdominal structures, provided there is a realistic chance of achieving adequate cytoreduction. The indication depends not only on the presence of disease, but also on its extent, distribution and the patient’s general condition.

In selected patients, surgery may be complemented by hyperthermic intraperitoneal chemotherapy (HIPEC), administered during the same surgical procedure to act directly on the peritoneal surface, or by pressurised intraperitoneal aerosol chemotherapy (PIPAC) in specific situations where a different approach is required.

The decision to combine these techniques is made on the basis of strict criteria relating to resectability, expected clinical benefit and consistency with the overall oncological strategy, thereby avoiding disproportionate treatments or those without a sound indication.

Proven expertise and support throughout every stage

The unit comprises surgeons specialising specifically in peritoneal oncology with extensive experience in highly technically complex procedures.

Co-ordinated work across specialities enables us to deliver a structured care pathway, with rigorous planning and continuous follow-up from the initial assessment through to the later stages of treatment.

Care is based on a person-centred model of medicine, which allows sufficient time to provide clear information, address concerns and facilitate informed, shared decision-making. Surgical complexity is thus integrated within a framework of medical responsibility, a supportive approach and constant support.