tbt4snow wrote:Thank you Pyro70. I have an option to go with local surgeon. But from what I read so far, the CRS is a very extensive procedure and you would benefit greatly if you go with an experienced surgeon. At MSK, I will have Dr. Nash. My local surgeon is board certified in 2013. I saw a negative review on the surgeon from vitals. com. That scared me off greatly. From your signature, you have done HIPEC twice. Did you have it done as MSK? You don't think HIPEC will help much with peri met from CC?
CRS is a very extensive surgery and you should want to go with a team that is very experienced at a high volume center. I used Dr Berri in Michigan, who happens to be local for me. He does a lot of HIPEC and is likely No. 2 in terms of volume in the US. I have high expectations of surgeons, and I was impressed by his level of dedication. I’m sure though there are other surgeons that are just as good at this procedure.
The best data we now have is from Prodige 7, it compared CRS only to CRS with HIPEC. It showed no survival benefit for the HIPEC arm with the exception maybe of people with a medium PCI. Given this data, and the other trial that looked at adjuvant HIPEC, I think we have to assume HIPEC is not helpful for CRC patients, however, CRS propably is (we don’t know for sure). On the other hand HIPEC doesn’t have too many complications so maybe it’s worth a shot especially if you have a medium PCI.
If i were you i would look into getting an insurance that has coverage for a high volume center that does CRS. This can get very expensive without insurance. You also don’t have to do the surgery, systemic chemo only is a legitimate choice, especially if you are asymptomatic. https://www.onclive.com/conference-cove ... vanced-crc