Table 1 Patients’ selection criteria for repeated CRS/HIPEC

Histologic or cytologic diagnosis of PC

Extraperitoneal or liver metastases

Complete recovery from prior systemic chemotherapy or radiation treatments

Poor performance status (ECOG 2–3)

Tolerance of initial HIPEC without major morbidity

Multiple small bowel obstruction

Disease considered to be resectable based upon imaging

Biliary obstruction

Good performance status (ECOG 0–1)

Short bowel syndrome

Prior R0 or R1 resection during the first CRS

Severe malnutrition

Maintain of nutritional reserves (albumin >3 g/dl)

Short disease-free interval

Favorable tumor biology

Class III appearance of the small bowel

Interval between two procedures of 6–12 months