Who is candidate for CRS and HIPEC?
Clinical features suggesting a favorable outcome for use of cytoreductive surgery and hyperthermic perioperative chemotherapy in patients with peritoneal metastases:
- General medical condition compatible with survival and recovery from the procedure.
- Clinical information regarding the peritoneal metastases compatible with a complete or near complete cytoreduction.
- Relative sparing of the small bowel and colon.
- Absence of disease outside the abdomen/pelvis.
- If hepatic metastases are present, they are limited, compatible with wedge resection.
- Absence of disease within the porta hepatis.
- With a high-grade malignancy, a low or moderate peritoneal cancer index.
- A-symptomatic patient.
Clinical features suggesting cytoreductive surgery and hyperthermic intraperitoneal chemotherapy should NOT be recommended include:
- Poor performance status.
- Rapid progression of a high-grade disease process.
- Low likelihood of a response to perioperative chemotherapy.
- Prior abdominal or pelvic radiation therapy.
- Asymptomatic from peritoneal metastases.