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Surgery for Peritoneal Mesothelioma

Doctors can use several types of surgery to treat malignant peritoneal mesothelioma. The best is cytoreductive surgery, which allows doctors to remove all visible tumors from the abdomen. Several patients treated with cytoreductive surgery and heated chemotherapy (HIPEC) have become long-term survivors. We can help you find doctors for peritoneal mesothelioma surgery now.

Fact-Checked and Updated by: Jenna Tozzi, RN

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What Types of Surgery Treat Peritoneal Mesothelioma?

The most effective type of surgery for peritoneal mesothelioma is called cytoreductive surgery, where doctors remove cancer tumors from the abdominal cavity. Doctors then apply HIPEC — hot chemotherapy drugs — to the surgery site. This kills microscopic cancer cells that the surgery team couldn’t take out.

A group of doctors perform peritoneal mesothelioma surgery

Peritoneal mesothelioma patients treated with cytoreductive surgery and HIPEC live for nearly 4.5 years on average. Some patients have even lived for more than 15 years thanks to this cancer treatment.

Besides cytoreductive surgery, other surgeries for peritoneal mesothelioma include omentectomy (removal of the omentum, a tissue layer that covers abdominal organs) and paracentesis (draining of fluid from abdominal lining).

Work with a peritoneal mesothelioma doctor to determine which surgeries will be best for your case.

Key Facts on Surgery for Peritoneal Mesothelioma

  • Where it’s performed: Abdomen, lining of the abdomen (peritoneum), and any organs that the cancer has grown into
  • Most responsive cell type: Epithelioid mesothelioma
  • Eligibility criteria: Must be in overall good health with minimal to no cancer spread
  • Survival rate: 65% of patients live for 5 years after getting cytoreduction surgery with HIPEC

Our nurses and Patient Advocates can help you find top local doctors who offer peritoneal mesothelioma surgery. Get started with our Free Doctor Match.

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Types of Surgeries for Peritoneal Mesothelioma

There are different types of peritoneal mesothelioma surgery that aim to remove cancerous tissue, alleviate symptoms, and improve overall quality of life.

Learn more about the surgical options available for peritoneal mesothelioma, including their impact on patient prognosis.

Cytoreductive Surgery With HIPEC

The gold standard in treating peritoneal mesothelioma is cytoreductive surgery with HIPEC.

Doctors first use cytoreductive surgery (also known as cytoreduction or debulking) to remove cancer from the abdomen.

What cytoreductive surgery means is that all the disease that we can see in the abdomen, we remove. So if it’s from the top of your abdomen by your diaphragm, if it’s on any of your internal organs, or if it’s in your pelvis, we remove that.”

— Dr. Fabian Johnston, cancer surgeon at Johns Hopkins Medicine

During cytoreduction, doctors may perform several surgical techniques to make sure they remove all of the cancer.

These include:

  • Laparotomy: The initial incision, which allows doctors to assess cancer spread
  • Peritonectomy: Taking out part of the peritoneum (abdominal lining) affected by cancer
  • Resection: Removal of parts of organs/tissues that cancer has grown into

After cytoreductive surgery, doctors bathe the abdomen with hyperthermic intraperitoneal chemotherapy (HIPEC) to kill the remaining cancer cells.

Warming the chemotherapy helps it to destroy more cancer cells. Further, bathing the surgery site limits the chemotherapy from harming healthy organs elsewhere in the body.

Cytoreductive surgery with HIPEC is very effective and helps many peritoneal mesothelioma patients live for several years. The average life expectancy of patients who get this treatment is 53 months, or about 4.5 years, according to a report in Cancer Management and Research.

Further, some patients can even live a decade or more thanks to cytoreduction with HIPEC.

Julie Gundlach
Point of Hope

Julie Gundlach has had five cytoreductive surgeries with HIPEC since her peritoneal mesothelioma diagnosis in 2006. When she first started treatment, doctors only gave her 6-12 months to live — but she is still alive today, more than 17 years later.


Doctors can perform an omentectomy to treat peritoneal mesothelioma in the omentum, the protective layer of tissue that covers the abdominal organs.

There are two omentectomy types:

  • Partial omentectomy: Removal of part of the omentum that the cancer has grown into
  • Total (supracolic) omentectomy: Extracting the entire omentum

Peritoneal mesothelioma doctors may perform a total omentectomy as part of a larger cytoreductive surgery with HIPEC.


A paracentesis is a palliative (symptom-relieving) surgery for peritoneal mesothelioma that doctors can use to relieve ascites (peritoneal effusions). Peritoneal effusions cause symptoms like abdominal pain, loss of appetite, and swelling.

To perform a paracentesis, doctors use anesthesia to numb the back. They then insert a needle and catheter (soft, flexible tube) to drain the peritoneal effusion.

This surgery doesn’t impact peritoneal mesothelioma life expectancy but can significantly improve quality of life by reducing common symptoms like stomach pain and bloating.

Doctors can also permanently insert a catheter to drain peritoneal effusions (ascites) that keep coming back after a paracentesis.

Our nurses and Patient Advocates can help you find the best peritoneal mesothelioma treatment options for your case. Call (866) 608-8933 now to get started.

Can I Get Surgery for Peritoneal Mesothelioma?

You may qualify to undergo peritoneal mesothelioma surgery if you meet specific criteria. Your doctor can determine if you’re a good fit or not.

Factors that affect eligibility for peritoneal mesothelioma surgery include:

  • Age: Younger patients may be in better health outside of having cancer and strong enough to more easily recover from a major surgery.
  • Cell type: Three mesothelioma cell types make up tumors. Epithelioid mesothelioma is the most common and can effectively be treated with surgery. Patients with the other cell types (sarcomatoid and biphasic) may not benefit from surgery.
  • Cancer spread: Patients whose cancer hasn’t spread far typically live longer after undergoing a major surgery for peritoneal mesothelioma. If cancer spreads to lymph nodes or out of the abdomen, patients may not live as long even with surgery.
  • Overall health: Patients must be in good overall health to receive cytoreductive surgery with HIPEC. This includes being physically fit and maintaining proper nutrition.

“A surgical oncologist with expertise in cytoreduction with HIPEC is the best person to discuss whether or not this treatment is an option for someone who has abdominal spread of cancer.”

Dr. Richard Alexander, peritoneal mesothelioma specialist

If you can’t get a major surgery, doctors can use other treatments to help fight your cancer and ease peritoneal mesothelioma symptoms.

Surgery in Peritoneal Mesothelioma Treatment Plans

Oncologists (cancer doctors) typically use surgery for peritoneal mesothelioma alongside other treatments to help patients live as long as possible.

Here’s how surgery works with other peritoneal mesothelioma treatments:

  • Chemotherapy: Outside of HIPEC, doctors can use chemotherapy drugs like pemetrexed and cisplatin to help patients live longer. The 5-year survival rate of peritoneal mesothelioma patients jumped to 80% when treated with cytoreduction, HIPEC, and additional chemotherapy, according to a 2022 study led by mesothelioma specialist Dr. Paul Sugarbaker.
  • Radiation therapy: Radiation allows doctors to shrink mesothelioma tumors prior to cytoreductive surgery. It may also be used after surgery to prevent cancer from recurring (growing back) along incision sites.
  • Clinical trials: Doctors study new ways to use surgeries and other peritoneal mesothelioma treatments through clinical trials. In December 2023, Dr. Paul Sugarbaker published a proposal for a clinical trial that would test the combination of systemic chemotherapy, chemotherapy in the abdominal lining, and cytoreductive surgery with HIPEC .

Get our Free Mesothelioma Guide shipped overnight to learn more about the different treatment options for this cancer.

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What to Expect During Peritoneal Mesothelioma Surgery

Your cancer care team will follow a series of steps so you can safely undergo and recover from a major surgery for peritoneal mesothelioma. Find out what to expect if you receive cytoreductive surgery and HIPEC below.

  1. Anesthesia: The medical team will give you general anesthesia through an IV line to ensure you are unconscious during the surgery and unable to feel pain.
  2. Laparotomy: Doctors make the first incision and then determine how much of the cancer can be removed.
  3. Cancer removal: Tumors are extracted from the peritoneum and abdominal cavity. Doctors also remove the omentum and sometimes parts of organs, depending on the cancer spread.
  4. HIPEC: Once all cancer tumors are removed, doctors send heated chemotherapy into the abdomen through a catheter, according to Johns Hopkins Medicine. The catheter links up to a machine that warms the chemotherapy to 103 degrees Fahrenheit and swirls it around the abdomen for 1-2 hours.
  5. Drain, rinse, and close incision: Doctors drain any leftover chemotherapy. They then rinse and sanitize the abdominal cavity using a saline solution and close the surgery site.

It takes 4-10 hours total for doctors to perform cytoreductive surgery with HIPEC, according to the University of Maryland Medical System.

Other surgeries for peritoneal mesothelioma take much less time. A paracentesis only takes 20-30 minutes, as noted by the Endoscopy Center of Red Bank.

Peritoneal Mesothelioma Surgery Recovery and Side Effects

After a major surgery for peritoneal mesothelioma, you need to recover in a hospital. Doctors will also monitor you for any potential side effects. Learn about surgery recovery times and side effects below.

Recovery and Side Effects of Cytoreductive Surgery

Following cytoreduction with HIPEC, you’ll need to remain in the hospital to recover for around a week to 10 days, as noted by Penn Medicine.

You will get nutrition through either a feeding tube or intravenously (through an IV) during this time. This is because your abdominal organs and digestive system need time to recover from the HIPEC.

Your surgical oncology team will also keep a close watch for side effects that could develop after cytoreductive surgery and HIPEC.

These potential side effects include:

  • Bleeding and blood clots
  • Bloating or swelling
  • Buildup of abdominal fluid (ascites)
  • Constipation
  • Fatigue
  • Insomnia and other sleeping problems
  • Nerve damage
  • Nausea and vomiting
  • Pain
  • Surgery site not healing
  • Weight loss

Before discharging you from the hospital, doctors will ensure that you can eat solid foods and provide medications to manage pain.

Patients can usually resume normal activities and work about a month after discharge, according to the University of Maryland Medical System.

Omentectomy Recovery and Risks

If you receive an omentectomy, you’ll typically only spend 2-3 nights at a hospital at the most. You may even go home the same day if doctors can remove the omentum without making a large incision.

You may experience pain for several days after an omentectomy as your body recovers. Doctors will also monitor you for side effects like problems passing urine or stool, infections, digestive tract obstruction, and more.

Paracentesis Recovery and Side Effects

After getting a paracentesis, doctors will have you rest for 1-2 hours in the hospital before allowing you to go home.

You’ll also be monitored for possible side effects of the procedure, including:

  • Abdominal pain
  • Blood or drainage from surgery site
  • Fever
  • Internal bleeding
  • Low blood pressure
  • Reduced kidney function

Contact your doctor if you start developing any of these symptoms.

How Surgery for Peritoneal Mesothelioma Improves Prognosis

Patients often have a better prognosis (expected health outcome) after getting cytoreductive surgery for peritoneal mesothelioma.

Did You Know?

The average life expectancy of peritoneal mesothelioma patients treated with cytoreductive surgery and HIPEC is roughly 53 months.

Further, the 5-year survival rate of patients who are treated using cytoreduction with HIPEC is 65% meaning many patients are still alive 5 years after getting this treatment.

Some patients can even achieve remission thanks to this treatment, according to the American Cancer Society (ACS). Remission happens when a patient has fewer or no signs of cancer.

Mary Jane Williams
Point of Hope

Two surgeries and five months of chemotherapy sent Mary Jane Williams’ peritoneal mesothelioma into remission a year after her diagnosis in 2003. She passed away in 2018 without her cancer coming back.

Without any type of treatment, peritoneal mesothelioma patients typically live 6-12 months on average.

Our team can help you find nearby doctors who offer surgery for peritoneal mesothelioma so you can hopefully live longer. Use our Free Doctor Match now to start the process.

Mesothelioma doctor talking with an older couple
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Cost of Peritoneal Mesothelioma Surgery

The cost of peritoneal mesothelioma surgery depends on many factors, including the type of surgery, medical provider, and facility. That said, treatments can be very costly.

For example, the cost of cytoreductive with HIPEC ranges from over $38,000 to nearly $50,000. Paracentesis can cost anywhere from $8,400 to $10,000.

Other treatment-related costs can quickly add up even with insurance. For example, you may need to travel to get a peritoneal mesothelioma surgery, paying for hotels, taxis, gas, plane tickets, or meals out of pocket.

Mesothelioma Hope can see if you’re eligible for financial assistance to cover the costs of surgery for peritoneal mesothelioma and other medical expenses. You may be able to secure $1 million or more in compensation that can help you afford the care you need.

Our legal partners have secured the following for past peritoneal mesothelioma patients:

  • $3.8 million for a restaurant worker
  • $3.6 million for a delivery worker
  • $1.88 million for the family of a 70-year-old Army veteran
  • $1.38 million for an Army veteran

We may be able to help you and your loved ones, too. Contact us now to get help affording surgery for peritoneal mesothelioma.

Get Surgery for Peritoneal Mesothelioma Now

By getting surgery for peritoneal mesothelioma, you have a better chance of becoming a long-term survivor. Thanks to cytoreductive surgery with HIPEC and other surgeries, more patients are living longer with peritoneal mesothelioma.

To get the best peritoneal mesothelioma surgeries, you need to find expert doctors who specifically treat this cancer. Fortunately, Mesothelioma Hope has relationships with some of the best peritoneal mesothelioma doctors in the country.

Use our Free Doctor Match or call (866) 608-8933 to find top specialists who offer peritoneal mesothelioma surgeries. Our caring nurses and Patient Advocates can help you pick the right doctor and even schedule your first appointment.

Surgery for Peritoneal Mesothelioma FAQs

What is the surgery for mesothelioma in the abdomen?

The most commonly used surgery for peritoneal mesothelioma (which forms in the abdominal cavity) is cytoreduction with heated chemotherapy (HIPEC).

Doctors first perform cytoreductive surgery to take out all of the tumors that they can see before dousing the abdominal cavity with hot chemotherapy to kill leftover cancer cells. This treatment allows patients to live over 4 years on average.

Less-intensive surgeries, including omentectomy or paracentesis, may also be used depending on the patient’s case.

What is the latest treatment for peritoneal mesothelioma?

A new treatment is combining HIPEC and surgery for peritoneal mesothelioma with traditional chemotherapy to help patients live longer.

A 2022 study led by  renowned peritoneal specialist Dr. Paul Sugarbaker found that patients who received cytoreductive surgery, HIPEC, and additional chemotherapy had a 5-year survival rate of 80%. This means that 8 out of 10 patients were still alive 5 years later.

Can surgery remove peritoneal cancer?

Yes, doctors can use surgery to remove peritoneal mesothelioma and other cancers. By taking out cancerous tumors, patients can often live longer and have a better quality of life.

We can help you find top local doctors who treat peritoneal mesothelioma with surgery. Contact us now to get started.

Can peritoneal mesothelioma go into remission after surgery?

Yes, peritoneal mesothelioma can sometimes go into remission after surgery, where the patient has fewer or no signs of cancer.

Talk to your gastrointestinal doctor to learn more about recovering from peritoneal mesothelioma and if remission might be possible in your case.

How successful is surgery for mesothelioma?

Peritoneal mesothelioma surgery can successfully remove all of a patient’s cancer, allowing them to live for many years in some cases.

Julie Gundlach, Mary Jane Williams, and Alexis Kidd have all lived 15 years or more after undergoing surgery for peritoneal mesothelioma.

Call (866) 608-8933 now to find doctors who can perform peritoneal mesothelioma surgeries that may help you or a loved one.

Jenna TozziWritten by:

Director of Patient Advocacy

Jenna Tozzi, RN, is the Director of Patient Advocacy at Mesothelioma Hope. With more than 15 years of experience as an adult and pediatric oncology nurse navigator, Jenna provides exceptional guidance and support to mesothelioma patients and their loved ones. Jenna has been featured in Oncology Nursing News and is a member of the Academy of Oncology Nurse & Patient Navigators & the American Nurses Association.

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