Morbidity and mortality of synchronous hepatectomy with cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (CRS/HIPEC)

There are relatively few operative indications for stage IV cancers. Notable exceptions include isolated lung or liver metastasis in GI cancers and cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis. The specific approaches to managing these metastatic lesions have been previously debated. For colorectal cancer patients presenting with synchronous hepatic metastasis, only a minority are suitable for resection (1). Synchronous resection for colon and rectal cancer is considered a safe and effective method of management in patients with isolated liver metastasis. However, there is some concern regarding the safety of synchronous resections when major hepatic resections are required, especially with higher risk colon and rectal resections (1,2)