Precision Diagnostics and the PCI Score
1. Specialized Oncology Consultation
Because peritoneal cancer involves the lining of the entire abdomen, precise staging is critical to determine if cytoreductive surgery is possible.
Your Consultation in Istanbul:
- Advanced Imaging: Utilizing PET-CT and high-resolution MRI to map the extent of the disease and calculate the Peritoneal Cancer Index (PCI) score, which guides the surgical plan.
- Multidisciplinary Board: Your case is reviewed by surgical oncologists, medical oncologists, and radiologists to define the optimal sequence of surgery and systemic chemotherapy.
- Diagnostic Laparoscopy: In some cases, a minimally invasive look inside the abdomen is performed first to directly assess the tumor burden before planning a massive surgery.
The Two-Step Eradication Strategy
2. Surgical Excellence: CRS & HIPEC
The combination of Cytoreductive Surgery (CRS) and HIPEC is currently the most effective treatment for peritoneal carcinomatosis.
The Surgical Procedure:
- Step 1: Cytoreductive Surgery (CRS): This is a massive, complex operation where the surgeon meticulously removes all visible tumors from the abdominal cavity. This often involves stripping the peritoneal lining and removing affected parts of the bowel, spleen, or other organs (optimal debulking).
- Step 2: HIPEC Therapy: Immediately after the visible tumors are removed, highly concentrated, heated chemotherapy is circulated directly into the abdominal cavity for 60 to 90 minutes. The heat increases the chemotherapy’s penetration, destroying any remaining microscopic cancer cells while minimizing systemic side effects.
Safe Recovery and Monitoring
3. Post-Operative Care and Intensive Recovery
CRS + HIPEC is colloquially known as the ‘Mother of All Surgeries’ (MOAS). Recovery requires intensive, specialized care.
Recovery Milestones:
- ICU Monitoring: You will spend the first 2-5 days in the Intensive Care Unit for close monitoring of your fluid balance, kidney function, and vital signs.
- Nutritional & Digestive Support: Because parts of the bowel may have been removed, our clinical dietitians will guide you through a specialized, progressive diet to safely restart your digestive system.
- Pain Management: Advanced epidural or PCA protocols ensure you are comfortable, allowing you to breathe deeply and begin gentle mobility early to prevent complications.
Our team provides comprehensive guidance and coordinates your ongoing systemic chemotherapy (if needed) before your return home.