Conditions/Oncologic surgery
Peritoneal Metastasis, CRS & HIPEC
Two components — not a miracle package for everyone
First question: is complete cytoreduction possible? HIPEC is not automatic.
Cytoreductive surgery (CRS) and HIPEC are related but separate. CRS aims to remove visible peritoneal disease; HIPEC adds heated intraperitoneal chemotherapy in selected protocols afterward. HIPEC is not standard for all peritoneal disease and is not an automatic add-on to every CRS. In colorectal peritoneal metastases, PRODIGE-7 showed no overall-survival benefit for oxaliplatin HIPEC — this must be discussed honestly. PCI score, primary tumor type, fitness, and likelihood of complete cytoreduction decide candidacy. If you are not a candidate, saying so clearly is better than the wrong large operation.
Educational figures
Tap a figure to enlarge. These English illustrations mirror the Turkish hub gallery for this condition.
What it is Candidacy Process Limits
CRS ≠ HIPEC
Clear the disease first; heated chemo is an add-on in selected cases.
PRODIGE-7
Oxaliplatin HIPEC is not a general overall-survival miracle in colorectal PM.
Selection
PCI, primary tumor type, and fitness matter.
Honesty
If you are not a candidate, we say so clearly.
Key points for patients
- What CRS meansTap for details
Surgical removal of visible peritoneal disease aiming for completeness (CC-0/CC-1). Incomplete cytoreduction rarely justifies maximal morbidity.
- What HIPEC meansTap for details · key note insideNoteHIPEC is not standard for everyone.
Heated intraperitoneal chemotherapy after CRS in selected protocols — not mandatory for every CRS.
- Evidence boundariesTap for details · key note inside
In colorectal peritoneal metastases, oxaliplatin HIPEC did not improve overall survival in PRODIGE-7. Other histologies and protocols have different evidence weight.
- Gastric + extensive peritoneumTap for details · key note inside
Gastric cancer with extensive peritoneal disease rarely fits a curative HIPEC narrative. Goals must stay realistic.
- Who is reviewedTap for details
Patients with limited PCI, favorable biology, and fitness for major surgery are discussed in multidisciplinary settings with complete imaging and prior operative records.
Patient journey
In this hub — follow the pathway step by step. Full Turkish illustrated pages remain linked from each chapter.
- 1
What CRS and HIPEC Are
Cytoreductive surgery vs HIPEC — related but not identical
Continue this step → - 2
CRS / HIPEC Eligibility
Eligibility — explained for shared decision-making
Continue this step → - 3
CRS / HIPEC Process
Process — explained for shared decision-making
Continue this step → - 4
Limits of CRS / HIPEC
Limits — explained for shared decision-making
Continue this step →
Appointment / info
Complete imaging and prior operative/pathology records are required for a serious CRS/HIPEC review.
Educational information only; not a substitute for clinical evaluation.
Medical editor: Assoc. Prof. Cengiz Dibekoğlu, MD · English patient-education hub.