Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Abstract

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.