Treatment of Mesothelioma with CRS and HIPEC - hyperthermic intraperitoneal chemotherapy
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Department of Cardiothoracic Surgery and Vascular Surgery
The Department of Cardiothoracic Surgery and Vascular Surgery provides effective surgical treatment for diseases of the heart, respiratory system, and blood vessels. The team of cardiac surgeons operates on patients with heart valve pathologies, coronary heart disease, heart failure, and heart rhythm disturbances. In the field of thoracic surgery, the key focus is on the surgical removal of lung tumors and lung metastases. The specialists in this area also perform surgery to repair chest wall deformities. In the field of vascular surgery, interventions for abdominal and thoracic aortic aneurysms are most often performed here. The department's vascular surgeons are also exceptionally competent in the treatment of peripheral occlusive arterial disease. A great advantage for the department's patients is that almost all surgical interventions are performed using minimally invasive techniques, so there is no need for a long postoperative recovery. The department's operating rooms are equipped with state-of-the-art technology. This allows for effective and safe treatment. The priority is always personalized medical care for patients.
Department of Abdominal and Colorectal Surgery, Hepatobiliary Surgery, Hernia Surgery, Bariatric Surgery, Endocrine Surgery, Thoracic and Vascular Surgery
The Department of Abdominal and Colorectal Surgery, Hepatobiliary Surgery, Hernia Surgery, Bariatric Surgery, Endocrine Surgery, Thoracic and Vascular Surgery offers the full range of services in these medical fields. It provides surgical treatment of diseases of the gastrointestinal tract, thyroid and parathyroid glands, thoracic organs, vascular system, rectum, anus and colon. In addition, the department performs bariatric interventions for the treatment of morbid obesity. A special focus is made on the treatment of gastrointestinal cancer. Minimally invasive surgical techniques are always preferred, if clinically indicated. The team of the department's surgeons has 8 progressive operating rooms equipped with everything necessary for successful treatment. The department also has the da Vinci Xi surgical system for high-precision minimally invasive robot-assisted interventions. The patient's health is in the safe hands of the best German surgeons who have gone through a rigorous selection and have vast clinical experience.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top German medical institutions specializing in the surgical treatment of heart diseases! The department offers the full range of first-class medical care for patients with diseases of the heart and thoracic organs that require surgical treatment. The availability in the department of advanced technical base allows for the most sparing treatment and minimally invasive surgery. The main focuses of clinical practice include coronary artery bypass grafting, modern procedures for heart valve reconstruction and replacement, treatment of diseases of the thoracic aorta, as well as treatment of heart failure by implanting an artificial heart.
Department of Abdominal, Thoracic and Vascular Surgery
The Department of Abdominal, Thoracic and Vascular Surgery offers all modern surgical interventions in these fields. Specialization covers the treatment of diseases of the abdominal organs, endocrine glands, pathologies of the lungs and chest wall, pathological vascular lesions of all parts of the body. In addition, kidney transplantation and pancreas transplantation are part of the surgeons' tasks. Whenever possible, operations are performed using minimally invasive techniques that have several advantages over classical interventions.
Department of Thoracic Surgery
The Department of Thoracic Surgery offers all types of modern surgical interventions for the treatment of diseases of the lungs, thorax and mediastinal organs. The team of the department's surgeons specializes in operations of any complexity, ranging from minor diagnostic interventional procedures to serious operations using a heart-lung machine. One of the key clinical interests of the department's doctors is lung cancer treatment. The patients with this diagnosis receive interdisciplinary treatment that combines tumor resection, radiation therapy, and chemotherapy. Another area of specialization of the medical facility is laser thoracic surgery, which allows preserving the lung parenchyma, for example, in the treatment of lung metastases. The range of services is complemented by surgical correction of thoracic deformities in adults, for example, pectus excavatum, and minimally invasive endoscopic treatment of hyperhidrosis. In addition, the department's thoracic surgeons have a wealth of experience in innovative video-assisted thoracoscopic surgery.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery is included in the ranking of the top German departments specializing in the surgical treatment of cardiovascular diseases! The department offers the full range of treatment of various diseases of the heart, blood vessels, organs of the respiratory system in adults and children. As part of the German Heart Competence Centre Tuebingen, the department is distinguished by the outstanding quality of medical care, competent specialists, as well as high-tech equipment of the latest generation.
Department of General and Abdominal Surgery, Hernia Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Endocrine Surgery, Thoracic Surgery and Bariatric Surgery
According to the Focus magazine, the Department of General and Abdominal Surgery, Hernia Surgery, Hepatopancreatobiliary Surgery, Colorectal Surgery, Endocrine Surgery, Thoracic Surgery and Bariatric Surgery is one of the best medical facilities in Germany for colorectal cancer treatment! The department offers a full range of surgical treatment in its areas of specialization. The department successfully operates on patients with diseases of the digestive tract, hernias, pathologies of the liver and gallbladder, colon and rectum, thyroid gland and parathyroid glands, as well as diseases of the lungs, pleura, and chest wall. The department offers all currently available surgical procedures for the treatment of morbid obesity. Bariatric surgery is performed in the Center of Excellence certified by the German Society for General and Visceral Surgery (DGAV). It should be noted that the department has a reputation as one of the best medical institutions in Germany with enormous experience in the field of pancreatic and esophageal surgery and resection of periampullary tumors. Almost all surgical procedures in the department are performed using minimally invasive and robotic techniques. This treatment provides good results while minimizing postoperative recovery time and eliminating serious surgical risks. The department also provides innovative treatment of peritoneal carcinomatosis using HIPEC, hyperthermic intraperitoneal chemotherapy. The department performs more than 5,100 surgical procedures of varying complexity each year, most of them on an outpatient basis.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery is included in the ranking of the top departments in Germany specializing in the surgical treatment of diseases of the cardiovascular system! The department offers the surgical treatment of all congenital and acquired heart diseases in adulthood, including heart transplantation, as well as the treatment of respiratory diseases in adults and children. It performs more than 2,000 interventions on the heart and about 600 operations on the lungs every year.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top medical facilities in the field of its specialization! The department offers all options of modern surgery for the treatment of diseases of the cardiovascular system and thoracic organs. The department widely uses modern minimally invasive techniques, which are considered the gold standard of surgery. Since its founding in 1976, the department has performed more than 40,000 open heart interventions. The department's surgeons also have vast experience in the field of implantation of the artificial heart and mechanical heart support systems. All operations are carried out in strict accordance with the protocols of professional societies.
Department of Adult and Pediatric Thoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Thoracic Surgery ranks among the top German departments in the treatment of lung cancer! The department offers the full range of diagnostics and treatment of diseases of the thoracic organs. The department is among the largest and oldest medical facilities of this kind in Europe. The doctors of the department mostly have to deal with diseases, such as lung cancer, lung metastases, pleural mesothelioma, sarcoma, myasthenia gravis, pulmonary emphysema, and thoracic defects. More than 2,300 surgical interventions of varying severity are performed here annually. For the achievements in the field of lung cancer treatment, the department received a certificate from the German Cancer Society.
Department of Cardiothoracic Surgery
According to the Focus magazine, the Department of Cardiothoracic Surgery ranks among the top medical facilities of this kind in Germany! The department offers the full range of surgical treatment of diseases of the cardiovascular system and thoracic organs in adults. Of particular interest is sparing minimally invasive surgery, particularly, heart valve interventions and coronary artery bypass grafting. Such interventions are carried out using the innovative da Vinci surgical system. The video-assisted thoracic surgical methods are widely used in the surgical treatment of thoracic diseases as well. All the department's specialists have excellent qualifications and vast clinical experience, which in combination with the cutting-edge technologies allows doctors to achieve the outstanding treatment results.
Department of General, Abdominal, Thoracic and Vascular Surgery
The Department of General, Abdominal, Thoracic and Vascular Surgery offers the full range of diagnostic and treatment services in these fields. The special competence of the department’s specialists lies in the field of surgical treatment of malignant diseases of the esophagus, stomach, intestines, liver, pancreas, lungs, thyroid, adrenal glands and tumor metastases in tissues and organs. The service spectrum is complemented by transplant surgery, namely liver and pancreas transplantations. Key role is played by interdisciplinary collaboration.
Department of Cardiac Surgery
The Department of Cardiac Surgery specializes in a full range of cardiac surgical procedures. The medical facility performs operations for ischemic heart disease, valvular heart disease, arrhythmias, heart failure, aortic aneurysms, and aortic dissections. The department's cardiac surgeons have successful experience implanting mechanical circulatory support systems in patients with heart failure: Impella®, ProtekDuo®, and LVAD devices are implanted here. Of particular interest is minimally invasive surgery, which, in addition to an optimal functional outcome, ensures minimal trauma rate, rapid recovery, and the absence of cosmetic defects. In cooperation with interventional cardiologists, the department's surgeons also perform hybrid heart operations, combining catheter-based and classical surgical techniques. The department has the prestigious DIN EN ISO 9001:2015 certificate, given only to the best clinics with exceptional quality of medical services. The department also has the status of a national Heart Failure Center, certified by the German Cardiac Society (DGK) and the German Society for Thoracic and Cardiovascular Surgery (DGTHG).
Department of Thoracic Surgery
The Department of Thoracic Surgery offers modern and the most sparing surgical treatment of the full range of diseases of the chest organs. Particular attention is paid to the treatment of malignant tumors of the lungs, pleura, and mediastinum, and lung metastases. The medical facility is certified as a Lung Cancer Center by the German Cancer Society (DKG). Such a quality certificate testifies to the outstanding quality of lung cancer treatment, which belongs to a group of particularly complex malignant diseases. The team of surgeons also has excellent professional skills in treating emphysema, pneumothorax, pleural empyema, and pleurisy. The department performs all surgical interventions in the field of reconstructive thoracic surgery, including the repair of pectus carinatum and pectus excavatum. The department is a Center of Excellence for Lung Transplant (Munich Lung Transplant Group, MLTG) and performs the largest number of lung transplants in all of Germany. The department's surgeons have a perfect command of minimally invasive and endoscopic techniques, so the number of classic open surgeries is negligible.
Department of Adult and Pediatric Cardiothoracic Surgery
According to the Focus magazine, the Department of Adult and Pediatric Cardiothoracic Surgery ranks among the top German departments specializing in the surgical treatment of diseases of the cardiovascular system! The department offers the full range of surgical treatment of diseases of the heart, lungs, and other thoracic organs. The department has a long and successful history. It has performed more than 50,000 heart surgeries since 1938. The first open-heart surgery under hypothermia, the first heart valve replacement surgery, as well as the first pacemaker and cardioverter-defibrillator implantations in Germany should be mentioned among the department’s achievements.
Department of Cardiac Surgery, Adult and Pediatric Thoracic Surgery
According to the Focus magazine, the Department of Cardiac Surgery, Adult and Pediatric Thoracic Surgery ranks among the top German medical facilities specializing in cardiac surgery! The department offers the full range of surgical treatment of diseases of the heart, lungs, thoracic organs, mediastinum and diaphragm, including heart and lung transplantation. With appropriate indications, the operations are performed using sparing minimally invasive techniques. The department's surgeons perform more than 3,000 surgical interventions annually, 200 of them using a heart-lung machine.
Mesothelioma, a rare yet aggressive cancer, mainly affects the protective membranes surrounding the lungs and abdomen. Approximately four out of five cases develop due to contact with asbestos — a hazardous substance that, despite its proven role as a carcinogen, is still often used in multiple industries, such as construction. Choosing the right mesothelioma treatment can substantially improve a patient’s prognosis.
Newer methods of treatment like cytoreductive surgery (CRS) combined with mesothelioma hyperthermic intraperitoneal chemotherapy (HIPEC) are showing very encouraging results. They have been proven highly efficient and often help to prolong a patient’s life for years.
Content
- What are CRS and HIPEC?
- Advantages of CRS and HIPEC in mesothelioma treatment
- Quality treatment in Germany
Pleural mesothelioma is a rare malignant tumor, the only form of pleural cancer.
The aim of CRS (cytoreductive surgery) is to remove as much of the malignant tissue as possible.
HIPEC, hyperthermic intraperitoneal chemotherapy, is a method of chemotherapy in which liquid drugs are placed into the abdominal cavity. For pleural mesothelioma, its modification HITOC is used.
HITOC is performed in the presence of multiple malignant foci on the pleura and lesions of lymph nodes.
For a better view of the operating field, CRS is performed in an open way. The surgeon revises the inside of the chest and removes all malignant foci.
HITOC destroys microscopic tumor metastases that cannot be visualized and removed during surgery.
HITOC does not have the side effects of chemotherapy. However, the results of HITOC are even better due to the high dosage of drugs and their active penetration into the affected tissues.
The University Hospital Ulm, University Hospital Frankfurt-am-Main and the University Hospital Marburg UKGM specialize in the treatment and postoperative recovery of patients with pleural mesothelioma.
The cost of the treatment ranges from 52 to 80,000 euros. On the Booking Health website you will find a list of clinics with current prices.
What are CRS and HIPEC?
CRS, or cytoreductive surgery, is a pivotal step in treating certain cancer types, including mesothelioma. First, doctors aim to remove all visible tumors from the abdominal cavity. Since mesothelioma targets the pleura (the protective lining around the lungs) specialists often perform a surgery called pleurectomy to remove the impacted tissue. This procedure demands considerable expertise and a particularly careful approach.
Following the CRS stage is the HIPEC procedure. HIPEC is a method wherein the abdominal cavity is flushed with heated chemotherapeutic drugs to eradicate any remaining cancerous cells that might have been overlooked during surgery. The idea behind HIPEC for mesothelioma treatment is that healthy cells perish at 44°C, while malignant ones do at 40°C. During the procedure, the drug solution is heated to temperatures between 40°C and 42.8°C. This way, the treatment selectively targets and eliminates cancer cells, largely sparing the healthy ones.
The HIPEC procedure includes several steps:
- The patient's abdominal cavity is infused with heated chemotherapeutic drugs.
- These substances circulate within the abdomen for 1-2 hours, effectively killing cancer cells due to the elevated temperature.
- Afterwards, the solution is removed, and the patient's abdominal cavity is rinsed.
The effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) is attributed to the elevated temperatures of the chemotherapeutic drugs, making them more potent in destroying cancer cells. When combined with CRS, HIPEC provides a highly effective treatment option that improves the chances of longer survival. Though, this complex treatment requires highly experienced doctors, special equipment, and careful planning. Therefore, selecting a well-equipped medical center and a competent team of specialists in abdominal and thoracic surgery is important. To help you make your decision, you can find more detailes about HIPEC procedure here.
Advantages of CRS and HIPEC in mesothelioma treatment
Based on a meta-analysis in the Annals of Surgical Oncology, using CRS and HIPEC significantly improves results of mesothelioma treatment. Specifically, these methods:
- Enable chemotherapy drugs to be delivered directly into the abdomen at high doses.
- Extend lifespan. Average survival rates for patients undergoing these treatments range between 4 and 8 years.
- Help to lower the risk of the cancer reappearing post-surgery.
- Alleviate pronounced symptoms.
- Tend to cause fewer adverse effects compared to standard intravenous chemotherapy for mesothelioma, due to the localized application of medications.
Many of the benefits of HIPEC are related to the method of drug administration. The impact of the heated chemotherapeutic agent is confined only to the abdominal cavity. This allows patients to receive the drug in higher doses.
Quality treatment in Germany
Germany is widely recognized as a global leader in oncology, and many patients travel to this country specifically to receive effective cancer treatment. German specialists and hospitals demonstrate impressive results in battling oncological diseases, including the successful application of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. The cost of HIPEC ranges from €51.792 to €80.119 and depends on the type of cancer, the extent to which it has spread and the level of the hospital.
Among the best clinics in Germany offering such treatment options are:
- Helios Clinic in Krefeld. The Department of Abdominal and Minimally Invasive Surgery specializes in CRS and HIPEC, among other things.
- Charité University Hospital. It's considered one of the most influential medical centers in Europe. The Department of General, Abdominal, and Vascular Surgery performs operations using hyperthermic chemotherapy.
- Ludwig Maximilian University Hospital of Munich. It is often mentioned among the top medical institutions in Germany, specializing in the treatment of abdominal tumors.
The doctors at these centers know a lot about treating mesothelioma and often see patients from abroad. They also pay attention to the rehabilitation after CRS and HIPEC. If you are diagnosed with this condition, you can plan your whole treatment through Booking Health. The company has been helping patients for more than 12 years. Specifically, it assists with hospital selection, offers the most promising treatment options, finds the best prices, provides the opportunity to reduce the cost of therapy, helps you schedule the appointment, coordinates the entire process, assists in hotel and flight booking. By entrusting the organizational processes to Booking Health, you can be confident in the quality of treatment received and fully focus on your recovery.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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