Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Michael A. Valente, Brendan John Moran
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy is a topic covered in the ASCRS Textbook of Colon and Rectal Surgery.

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Key Concepts

  • Peritoneal dissemination is a frequent occurrence in the natural history of colorectal cancer, which may be synchronous or metachronous.
  • The clinical benefit of systemic chemotherapy in patients with colorectal peritoneal metastases is less than in patients with other metastatic sites.
  • A substantial survival benefit, with some patients cured, can be achieved in selected patients undergoing CRS and HIPEC.
  • Outcome of CRS and HIPEC for colorectal peritoneal metastases is best in patients with low disease burden and complete cytoreduction.
  • Currently, a shift in focus is taking place from treatment of established colorectal peritoneal metastases to prevention and early detection, by identification of patients at high risk for developing colorectal peritoneal metastases.
  • Combining CRS and HIPEC with limited resection of liver metastases is feasible and achieves good oncological outcomes in a highly selected group of patients.

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Key Concepts

  • Peritoneal dissemination is a frequent occurrence in the natural history of colorectal cancer, which may be synchronous or metachronous.
  • The clinical benefit of systemic chemotherapy in patients with colorectal peritoneal metastases is less than in patients with other metastatic sites.
  • A substantial survival benefit, with some patients cured, can be achieved in selected patients undergoing CRS and HIPEC.
  • Outcome of CRS and HIPEC for colorectal peritoneal metastases is best in patients with low disease burden and complete cytoreduction.
  • Currently, a shift in focus is taking place from treatment of established colorectal peritoneal metastases to prevention and early detection, by identification of patients at high risk for developing colorectal peritoneal metastases.
  • Combining CRS and HIPEC with limited resection of liver metastases is feasible and achieves good oncological outcomes in a highly selected group of patients.

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Last updated: January 26, 2022