ABSTRACT
The use of cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal surface disease (PSD) from colorectal cancer is a more recent development in oncologic surgery. Systemic chemotherapy for metastatic colorectal cancer has clearly improved significantly since the turn of the century. The treatment of metastatic colorectal cancer has undergone major changes. Despite the publication of consensus statements on the role of CS and HIPEC for PSD from colorectal cancer, the controversy continues regarding its efficacy, safety, and application in the patients. Patient Selection is imperative that appropriate candidates be selected for CS–HIPEC for peritoneal dissemination from any site, but particularly for colorectal cancer patients. Although distal rectal cancer arises in a retroperitoneal position, proximal rectal primary tumors can also be considered for HIPEC. Complete cytoreduction of all gross disease is the primary objective for CS prior to HIPEC. Operative mortality has been reported as high as 11% following CS–HIPEC, but is generally about 4%.
