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:

  1. General medical condition compatible with survival and recovery from the procedure.
  2. Clinical information regarding the peritoneal metastases compatible with a complete or near complete cytoreduction.
  3. Relative sparing of the small bowel and colon.
  4. Absence of disease outside the abdomen/pelvis.
  5. If hepatic metastases are present, they are limited, compatible with wedge resection.
  6. Absence of disease within the porta hepatis.
  7. With a high-grade malignancy, a low or moderate peritoneal cancer index.
  8. A-symptomatic patient.

Clinical features suggesting cytoreductive surgery and hyperthermic intraperitoneal chemotherapy should NOT be recommended include:

  1. Poor performance status.
  2. Rapid progression of a high-grade disease process.
  3. Low likelihood of a response to perioperative chemotherapy.
  4. Prior abdominal or pelvic radiation therapy.
  5. Asymptomatic from peritoneal metastases.