Cirrhosis is not a contraindication to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in highly selected patients

World J Surg Oncol. 2018 Apr 26;16(1):87. doi: 10.1186/s12957-018-1389-3.


Background: Patient selection for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is critically important to optimizing outcomes. There is currently no literature regarding the safety of CRS/HIPEC in patients with cirrhosis. The aim of this case series is to report the outcomes of three patients with well-compensated cirrhosis who underwent CRS/HIPEC.

Methods: Patients were identified from a prospectively maintained peritoneal surface malignancy database. Patient, tumor, and operative-related details were recorded as short-term postoperative outcomes. Results were analyzed using descriptive statistics.

Results: All patients had well-compensated (Child-Pugh Class A) cirrhosis and Eastern Cooperative Oncology Group (ECOG) performance status of 0. One patient had preoperative evidence of portal hypertension. All safely underwent CRS/HIPEC with completeness of cytoreduction (CC) scores of 0. The postoperative morbidity profile was unique, but all complications were manageable and resulted in full recovery to preoperative baseline status.

Conclusions: Patient selection for CRS/HIPEC is critical for optimization of short- and long-term outcomes. This small series suggests that well-compensated cirrhosis should not be an absolute contraindication to CRS/HIPEC.

Keywords: Cirrhosis; Cytoreduction; Cytoreductive surgery; HIPEC.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chemotherapy, Adjuvant
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Contraindications*
  • Cytoreduction Surgical Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperthermia, Induced / methods*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / therapy*
  • Male
  • Middle Aged
  • Patient Selection*
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / therapy*
  • Prognosis
  • Prospective Studies
  • Retrospective Studies