The paradigm of cytoreductive surgery or CRS has been induced with hyper-thermic intraperitoneal chemotherapy (HIPEC) to treat respectable peritoneal carcinomatosis in most effective way. Use of CRS for Carcinoma Ovary, Stomach Cancer and Colon Carcinomain technology by the best surgical oncologist has also helped in boosting the chances of survival for patients.
The basic principle of such surgery is to remove all the parietal peritoneum with visible tumor. Malignant cells tend to implant at sites in the abdomen where there is less movement of bowel and intraabdominal structures. Particularly where the bowel is fixed to the retroperitoneum and sites if absorption of peritoneal fluid including rectosigmoid , IC junction, antrum of stomach, lesser sac, greater and lesser omentum and right diaphragm. There are many instances of CRS + HIPEC in Kolkata.
- Colorectal cancer with peritoneal dissemination
- Carcinoma Ovary
- Primary Peritoneal malignancies
- Carcinoma Stomach
- Peritoneal mesothelioma
Absolute Contradiction For (CRS & HIPEC) :
- Extra abdominal disease
- Significant extraperitoneal disease, > 3 liver mets
- Large extraperitoneal lymph nodes
- Infiltrative tumor deposits at root of mesentry
- Unknown primary
Studies show significant increase in disease free survival and recurrence free survival in cases of Ovarian cancer, colorectal cancer and primary peritoneal carcinoma group.
Oncology is an ever evolving field of medicine and is matter of research and development. The author per say does not claim the following to be guidelines of practice in oncology. These are part of patient awareness initiative by Dr. Suvadip Chakrabarti MCh (Surgical Oncology) to educate people at large of various options in Oncology. It should not be taken to be practice guidelines.