Outcomes of Cytoreductive Surgery Combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Carcinomatosis

In recent years, CRS and HIPEC have become an innovative and potentially effective standard of care concerning PC, previously described as a condition with few treatment choices and poor outcomes. In this systematic review, outcomes of CRS-HIPEC were assessed based on survival, recurrence, and quality of life indices. Reports suggest that achieving molecular cytoreduction enhances the OS and PFS of the patients for this combined modality therapy. HIPEC delivers heated chemotherapy locally, thus increasing drug penetration and cytotoxicity that has a complimentary effect with surgery to eliminate the micro metastatic disease. Despite its potential for offering a curative treatment to patients with peritoneal malignancies, CRS-HIPEC is not without significant morbidity, and associated risks include infections, anastomotic leak, haematologic toxicity, and others. Patient selection remains a cornerstone because such variables as tumour histology, PCI, and performance status predict outcomes. This review also discusses the use of CRS-HIPEC in other cancers, such as colorectal cancer, ovarian cancer, and gastric cancer, to enhance survival rates as compared to the use of systemic therapy. Nevertheless, the variability of the studies in terms of design, samples, and chemotherapy makes the development of rigorous guidelines for best practices and fewer complications essential. Perioperative management and the additional use of organised enhanced recovery protocols are significant for managing treatment burden. As such, CRS-HIPEC acts as a paradigm shift for selected patients with PC, and more RCTs are required to optimise the criteria of patient enrollment, determine the long-term effects, and compare the procedure's cost-effectiveness. This review also highlights the need for caregivers to integrate an interdisciplinary approach to achieving the best CRS-HIPEC for patients with PC.