ABSTRACT
Laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) without cytoreductive surgery (CRS) can offer a palliative improvement by decreasing ascites, but it leaves the tumor burden unaddressed. CRS followed by HIPEC addresses tumor burden, but recovery takes up to 3–6 months. Even though HIPEC without CRS can control ascites more than 90% of the time, without complete CRS, no patient with primary other than low-grade appendiceal will achieve long-term survival. In order to determine which patients with ascites have higher chances to achieve a complete CRS, we have developed a scoring system. In cases where a complete CRS is not feasible and ascites is interfering with quality of life, the patient will be treated with laparoscopic HIPEC with or without omentectomy, only for symptom control and without further organ resection. Malignant ascites is a sign of advanced disease and an indication of low chances to achieve a complete CRS.
