Routinely proceeding with neoadjuvant chemotherapy (NAT) before cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for high-grade appendiceal neoplasms is a common practice at many HIPEC centers. The proposed tenets of that practice are that NAT chemotherapy limits progression of disease, improves the chances of a complete cytoreduction, and serves as a surgical selection tool. Yet, published literature supporting a true efficacy of NAT chemotherapy is lacking.
1‐3 Conversely, the risk profile with frequently utilized chemotherapy regimens is real and well documented. …