Treatment of liver metastases in patients selected for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis

Abstract

Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have gained increasing consensus in treatment of peritoneal carcinomatosis from colorectal cancer. The presence of liver metastases is generally considered a contraindication for CS + HIPEC, as hepatic involvement no longer represents a loco-regional aspect of disease. Despite this, liver resection (LR) has been tested in selected cases in combination with CS + HIPEC for treatment of peritoneal carcinomatosis with liver metastasis. Relevant studies on this topic were identified through a search in the electronic PubMed database, using the appropriate keywords. CS + HIPEC + LR allows similar outcomes in terms of survival and morbidity with respect to CS + HIPEC, especially in patients with low tumor load. CS + HIPEC + LR represents a reasonable approach for patients with peritoneal carcinomatosis and liver metastases from colorectal cancer. Patients should be selected in high volume tertiary centres, preferably in the context of a prospective trial