Cytoreductive Surgery Plus Hyperthermic Perioperative Chemotherapy for Selected Patients with Peritoneal Metastases from Colorectal Cancer: A New Standard of Care or an Experimental Approach?

Table 1

Cytoreductive surgery (CRS) and hyperthermic perioperative chemotherapy (HIPEC) for colorectal peritoneal metastases.

Credits	Debits
(i) Long-term survival in 30% of patients; (ii) Patients with minimal carcinomatosis experience best survival	(i) The cytoreductive surgical procedure is complex and requires an extended learning curve
(iii) Morbidity (12%) and mortality (1%) at experienced centers is possible	(ii) Surgical series contain patients who have received many different HIPEC regimens at many different timepoints in their treatment
	(iii) The relative roles of CRS and HIPEC in the causation of long-term survival have not been determined
	(iv) Seventy percent of patients in the literature went on to die of peritoneal metastases usually because HIPEC did not sustain the surgical complete response