Peritoneal Surface Malignancy Program

Peritoneal surface malignancy, commonly known as peritoneal carcinomatosis, is cancer within the peritoneal cavity. The peritoneal cavity is the space between the organs in the abdomen and is lined by the peritoneum, which is normally a thin protective membrane. Cancer of the peritoneum is often caused by the spread of cancer cells from pre-existing cancer. The most common cancers that cause peritoneal carcinomatosis are:

Peritoneal Surface Malignancy FAQ | Jonathan Greer, M.D.

Surgical oncologist Jonathan Greer discusses peritoneal surface malignancy, a tumor that has spread from a primary organ to the abdomen — more specifically, the lining of the abdominal cavity (or peritoneum) — and treatment options.

HIPEC: What You Need to Know | Fabian Johnston, M.D.

Surgical oncologist Fabian Johnston discusses cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC), a highly concentrated, heated chemotherapy treatment that is delivered directly to the abdomen during surgery and has been shown to be effective against primary peritoneal and other types of cancer.

Peritoneal Surface Malignancy Treatment

Cytoreductive Surgery and HIPEC

Due to recent advances in surgical techniques, we are now able to provide more treatment options for certain late stage cancers than ever before. A technique called tumor debulking, or cytoreductive surgery (CRS), and hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to be an effective treatment option for certain patients with peritoneal surface malignancy.

This complex surgical procedure is a two-step process:

  1. Surgically removing any visible tumor or cancer (CRS)
  2. Delivering heated chemotherapy drugs into the abdomen (HIPEC)

The first phase of treatment, CRS, involves removing any visible tumors in the abdomen, which may include involved organs.The extent of surgery will be determined by the amount of tumor in your abdomen. Surgeons carefully balance the risks and benefits of organ removal with your cancer treatment and overall health, and will discuss this with you extensively prior to surgery.

During the second phase of treatment, a heated chemotherapy solution is circulated in the abdominal cavity to treat any cancer cells that may remain.The combination of heat and chemotherapy delivered directly to your abdomen in the operating room is believed to be more effective than surgery alone for certain patients with peritoneal disease because it can access and kill more cancer cells than can be found with the naked eye.

Recent studies have shown that CRS/HIPEC is beneficial for certain patients with late-stage gastrointestinal cancers and ovarian cancer.The procedure can potentially prolong life and also improve quality of life for patients. Since the chemotherapy is delivered as a one-time dose directly into the abdomen, the traditional side effects of oral or intravenous chemotherapy drugs may be avoided; however, many patients do still require intravenous chemotherapy before or after surgery.

Quality of Care

A multidisciplinary team of health care professionals will carefully review your medical records and meet with you to determine if this operation may be an effective treatment for you. Two factors are critical for successful outcomes: First, careful patient selection to determine who may benefit the most with the least amount of risk, and second, performance of this operation at a busy national cancer center, such as The Johns Hopkins Hospital, by professionals experienced in the care of complex cancer patients.

Frequently Asked Questions about Peritoneal Surface Malignancy Treatment

Meet Our Experts

Our multidisciplinary team consists of surgeons, oncologists, advanced practice providers, radiologists, anesthesiologists, nurses, nutritionists and social workers who are all dedicated to providing holistic care based on the best evidence to improve patient outcomes and the quality of life for people diagnosed with peritoneal carcinomatosis.

Surgical Oncology

  • Jonathan Bruce Greer, M.D.

    • Director, Peritoneal Surface Malignancy Program
    • Program Director, Complex General Surgical Oncology Fellowship
    • Assistant Professor of Surgery
    • Assistant Professor of Oncology
  • Fabian Johnston, M.D., M.H.S.

    • Division Chief, Gastrointestinal (GI) Oncology
    • Associate Professor of Surgery
    • Associate Professor of Oncology

Nettles, Brenda Smith DNP, ACNP-BC

Nurse Practitioner Johns Hopkins University School of Medicine, Baltimore, Maryland

Brenda Nettles

Gynecology and Obstetrics

Rebecca Lynn Stone, M.D., M.S.

  • Director, The Kelly Gynecologic Oncology Service
  • Director, Enhanced Recovery after Surgery Program
  • Co-Director of the Johns Hopkins Fertility Preservation and Innovation Center
  • Associate Professor of Gynecology and Obstetrics

Medical Oncology

  • Nilofer Saba Azad, M.D.

    • Co-Director of Cancer Genetics and Epigenetics
    • Professor of Oncology
  • Katherine Meryl Bever, M.D.

    • Assistant Professor of Oncology
  • Dung Thi Le, M.D.

    • Bloomberg~Kimmel Professor of Cancer Immunotherapy
    • Professor of Oncology
  • Valerie Lee, M.D.

    • Assistant Professor of Oncology
  • Lei Zheng, M.D., Ph.D.

    • Co-Director, Pancreatic Cancer Precision Medicine Center of Excellence Program
    • Director, Multidisciplinary Gastrointestinal Cancer Laboratories Program
    • Director, NCI T32 Training Program on Surgical Oncology Research
    • Co-Associate Cancer Director for Precision Medicine
    • Assistant Cancer Director for Translational Research
    • Professor of Oncology
    • Professor of Surgery