Selection Criteria for Cytoreductive Surgery and Hipec for Treatment of Peritoneal Metastases
George Efthymiopoulos, Irina Noskova, John Spiliotis.
Peritoneal metastases (PM) from gastrointestinal and gynecological primaries pose a poor prognosis, but cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers potential survival benefits in select cases. This mini-review outlines key selection criteria: low disease burden (Peritoneal Cancer Index 70), manageable comorbidities, and favorable tumor biology. Completeness of cytoreduction (CC-0/1) is essential, best achieved in highvolume centers. Preoperative assessment via CT, MRI, PET, and laparoscopy guides decisions, with 3-year survival ranging from 5-10% (gastric PM) to 50-60% (ovarian PM). Multidisciplinary expertise optimizes outcomes while minimizing risks.
