Adjuvant HIPEC in colorectal cancer

Peritoneal carcinomatosis (PC) of colorectal origin has historically been regarded as fatal, with worse prognosis than other metastatic manifestations of the same origin. During the last three decades, complete cytoreductive surgery associated with adjuvant hyperthermic intraperitoneal chemotherapy (HIPEC) has led to improvement of outcome, with long-term survival being achieved for selected patients. This treatment is on the verge of becoming the standard of care for this metastatic disease. In this paper we review the rationale for HIPEC, the results obtained, and define its current indications. Future developments of HIPEC are also discussed, mainly its use as a prophylactic approach to prevent the occurrence of PC in high-risk patients.