Current Status of Peritoneal Surface Malignancy in Thailand

Peritoneal dissemination negatively affects the survival of cancer patients. Comprehensive treatment comprising of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) introduced by Dr. Paul H. Sugarbaker in 1980 has shown a benefit in survival especially in patients with gastrointestinal cancer and ovarian cancer. Thailand started to perform this integrated treatment in 2012. A modification of the heart-lung machine was used as the hyperthermic pump for the first few years. Until now, 240 cases have been treated in 7 centers. Although the Thai health care system covers all areas and is easy to access, many surgeons still doubt the benefit and safety of this treatment. This coupled with difficulty in procuring the equipment, and high procedural cost has resulted in few surgeons offering this treatment and fewer patients availing of it. The small group of peritoneal surface malignancy (PSM) surgeons tries to educate all health care providers to understand how it works in an advanced-stage cancer patient and to make this procedure be covered by the national health care policy.