In December, surgeons at UF Health performed their first cytoreductive surgery (CRS) and heated intraperitoneal chemotherapy (HIPEC) to treat abdominal cancer in an adult patient. The surgery was successful, and the patient has been discharged and seen in clinic during the postoperative follow up.
“I’m excited our adult patients with peritoneal surface malignancies will have access to this procedure,” said Ibrahim Nassour, M.D., an assistant professor in the division of surgical oncology at UF. “I couldn’t have done it without the help of my team, who were dedicated to the health of the patient and the success of the procedure.
Nassour worked with a range of providers, including other surgical services, pharmacists, perfusionists, residents, students, oncologist, radiologists, pathologists, and nurses.
The procedure, known as CRS/HIPEC, involves the surgical removal of visible tumors, followed by chemotherapy administered directly to the abdominal cavity to clear out remaining cancer cells. The chemotherapy solution is heated, which makes the tumors more permeable and responsive to treatment.
“Typically, we offer this operation for a very select patient population with cancers that spread to the abdominal cavity,” Nassour said.
Factors that are considered before offering this operation are origin of the peritoneal cancer, extent of the disease, spread of the cancer outside the abdominal cavity and how the patient is performing.
First, surgeons debulked and removed all visible tumors from the abdominal cavity. Then, a hot chemotherapy solution was pumped into the abdomen for 90 minutes. This helps in sterilizing any remaining cancer cells that the surgeon cannot see.
“The procedure’s duration can range from anywhere between 6 to 12 hours, while the average hospital stay is 7 to 14 days,” Nassour explained. “Primarily, the goal of this operation is to control symptoms, prevent cancer from returning and in, some cases, cure the cancer entirely.”
Although the procedure was first introduced many decades ago to treat very select tumor types, it is quickly becoming a popular abdominal cancer treatment due its effectiveness. Surgery is often the most effective treatment for gastrointestinal cancers.
Every year, UF Health surgeons in the UF Health GI Oncology Center see and treat more than 1,000 patients with gastrointestinal cancers, including patients with complicated cases whose tumors are considered inoperable at many other institutions.
“In cases like this, innovative treatment [like HIPEC/CRS] can be the key to saving and prolonging someone’s life,” Nassour said.
At UF Health, Nassour specializes in surgeries for cancers of the gastrointestinal tract, pancreas, liver and bile duct. Although he has a special interest in robotic pancreato-biliary surgeries, including robotic pancreaticoduodenectomy, he also specializes in regional therapies for metastatic disease such as peritoneal surface malignancies.