Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and Cytoreductive Surgery (CRS) for Colorectal Cancer: Potential for Individualized Care, Review of Current Treatment Trends, Recent Advancements, and a Look into the Future

Abstract

Purpose of Review

Peritoneal metastases (PM) secondary to colorectal cancer is associated with a poor prognosis. However, cytoreductive surgery with hyperthermia intraperitoneal chemotherapy (CRS/HIPEC) has risen to a more accepted roll in the treatment of peritoneal metastatic disease for various cancers; colorectal cancer is no exception. This review aims to discuss the recent updates and findings for treatment of peritoneal disease secondary to colorectal cancer, especially with respect to individualized patient factors that affect outcomes.

Recent Findings

There are many new studies showing the validity of cytoreductive surgery CRS/HIPEC in a select group of patients with PM. Many studies show that lower peritoneal cancer index score, use of various chemotherapeutic regimens, histology, preoperative health status, adequate nutrition, and other factors all benefit survival/treatment of this unique patient group.

Summary

Current evidence supports an aggressive multidisciplinary approach to peritoneal disease secondary to colorectal cancer. Standardized treatment practice, highly selective patient criteria, low PCI score, and early recognition of patients at risk for PM show survival benefits and better outcomes for patients with a disease process that was once only treated with palliative interventions.

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