Cytoreductive Surgery and HIPEC in the Elderly

Chapter

Abstract

Worldwide there has been an increase in the overall life expectancy, which has led to an increase in the aging/elderly population. The incidence of cancer has also increased as age is one of the known risk factors and, consequently, the incidence of patients with peritoneal metastases. Elderly patients with PM pose a therapeutic challenge to peritoneal surface oncologists. They can experience a significant prolongation in survival with CRS and HIPEC which needs to be balanced against the risk of increased morbidity. Preoperative evaluation of functional status using scores like the frailty index helps in selecting patients who have the physical reserve to withstand the procedure irrespective of the chronological age. A multidisciplinary evaluation is also needed to select patients who are most likely to derive a benefit, an oncological benefit. Patients with a low PCI and those who undergo complete cytoreduction and have PM from appendiceal primary tumor or peritoneal mesothelioma derive the maximum benefit. There is a higher incidence of medical complications in the elderly with a larger proportion of patients succumbing to their complications; hence all efforts should be made to avoid complications in these patients.

Keywords

Cytoreductive surgery HIPEC Elderly Peritoneal carcinomatosis Peritoneal metastases 

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of General and Oncological Surgery (Surgery-C)The Chaim Sheba Medical CenterTel HashomerIsrael

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