Optimal patient selection for cytoreductive surgery and HIPEC

The treatment of patients with peritoneal metastases from colorectal cancer origin is a multimodal treatment. This treatment consists of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC), whether or not combined with systemic chemotherapy. Optimal patient selection is necessary to select those patients who will benefit from this treatment. This selection process can be optimized improve the diagnostic tools, such as the diffusion weighted MRI and molecular diagnostics. In this thesis, several components from the HIPEC procedure are further investigated. Since cytoreductive surgery turned out to be effective, the benefit of the different components can be questioned.
Pseudomyxoma peritonei, a rare disease, is also discussed in this thesis. The long term survival, after treatment with cytoreductive surgery and HIPEC, is discussed. Besides male sex and incomplete cytoreduction, elevated tumour markers above a certain threshold are associated with poor survival.