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Initial Experience of Complete Cyto reductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) from a Tertiary Cancer Care Centre in India M D Ray, Seema Singh, Ashutosh Mishra, S.V.S Deo, N.K Shukla Introduction; Peritoneal metastasis in intraperitoneal visceral malignancies was earlier thought as incurable terminal disease but with the advent of Cytoreductive surgery and Hyperthemic Intraperitoneal chemotherapy (CRS+HIPEC) in the recent past, the approach to such cases have been changed with better oncological outcomes and acceptable morbidities and mortality. Materials and Methods: A prospective study was conducted between January 2015 to January 2017 in the department of Surgical Oncology at AIIMS; New Delhi. A total of 55 patients underwent CRS + HIPEC procedure at our centre. Preoperative assessment for cytoreduction was done using contrast CT-scan of the abdomen and PET scan as indicated. All procedures were performed by the same surgical team. After cytoreduction, HIPEC was performed by semi open method where different chemotherapeutic drugs were instilled and circulated in peritoneal cavity at the core temperature of 42 0C for 60 min . Results: Median patient age was 46 with 14.55 % male and 85.45 % female (F:M; 5.87). Majority (90.91 % were Performance status (ECOG 1 ) and remaining were ECOG 2. Median PCI was 7.5 (5-21). Ovarian cancers comprising the commonest one inclusive of both primary, after NACT and recurrent cases;65.45%; followed by Carcinoma Colo rectum, Pseudomyxoma peritonei, Peritoneal mesothelioma and Carcinoma Appendix in decreasing order. Fifty ( 90.91%) patients had a complete cytoreduction(CC 0) and acceptable cytoreduction (CC1)was achieved in 9.09% cases. Median duration of CRS and HIPEC was 7.3 hrs and patients were discharged after a median hospital stay of 7 days. Nausea and vomiting was the most common complication in early post operative period; followed by deep venous thrombosis in 10.09%, paralytic ileus in 9.09% and subacute intestinal obstruction in 5.45% cases in late post operative period. Most common cause of readmission was subacute intestinal obstruction (9.09%), which was managed conservatively. Three ( 5.45%) patients died in early postoperative period due to cardiopulmonary compromise . Seven ( 12.73%) patients developed recurrence ( local, 7.27%; local and systemic in 3.64%; systemic in 1.82%) which were managed either by systemic chemotherapy, surgery or palliative chemotherapy. Conclusion: Our initial results indicate that CRS + HIPEC procedure can be performed with acceptable morbidity however diffuse peritoneal disease is a predictor of high incidence of recurrence. Appropriate case selection by a multi-disciplinary team is vital to achieve complete cytoreduction and expected outcomes. [ABSTRACT FROM AUTHOR]