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Older Patients Can Safely Undergo CRS-HIPEC for Advanced Colorectal Cancer

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Survival and morbidity in elderly patients treated with cytoreductive surgery and HIPEC for colorectal peritoneal metastases a population-based study.DOI 10.108002656736.2026.2620731

Colorectal cancer can sometimes spread to the lining of the abdomen. Doctors call this peritoneal metastasis. One treatment option for selected patients is cytoreductive surgery (CRS) combined with heated chemotherapy inside the abdomen (HIPEC). This approach removes visible tumors and targets remaining cancer cells.
Doctors often worry that this complex surgery may be too risky for older patients, especially those aged 75 and above.
A large study from Sweden looked at 592 patients who underwent CRS-HIPEC for colorectal cancer with peritoneal metastases. Researchers compared outcomes between patients younger than 75 and those aged 75 or older.
The results showed that overall survival was similar in both age groups. Older patients did not have worse survival after the surgery.
Importantly, serious postoperative complications were also similar between younger and older patients. In fact, the rate of major complications was slightly lower in the older group. Hospital mortality was low overall, and no deaths occurred among patients aged 75 or older during hospitalization.
The study also identified factors that had a greater impact on survival than age. These included the extent of cancer spread in the abdomen and whether surgeons were able to remove all visible tumors.
These findings suggest that age alone should not prevent patients from receiving CRS-HIPEC. Carefully selected older patients can benefit from this treatment with outcomes similar to younger individuals.
Doctors may instead focus on the patient’s overall health, tumor burden, and surgical feasibility when deciding whether CRS-HIPEC is appropriate.

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dr swati shah - uro & gynec cancer surgeon
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