In case of PCI >20 a careful evalua

In case of PCI >20 a careful evaluation was made to see if CRS with CCS 0-1 was achievable. At least 2 m disease free small bowel including its mesentery was mandatory for continued CRS. In the judgement whether to proceed or not, the degree of invasiveness of PM into adjacent structures was also considered. CRS and HIPEC resulting in CCS=1 were included in the analysis but three patients with CCS=2 operated in 2005-2006 with CRS + HIPEC were excluded from the analysis. The term open-close was used when the intention was to perform CRS and HIPEC but the patient was considered to be inoperable after exploration and only biopsies were taken and the abdomen was closed again. The term debulking was used in the same situation but when the surgeon decided to excise some major tumour mass such as ovarian metastasis or omental cake without any radical operation performed. Patients treated with open-close or debulking are analysed together in this study and are herein referred to as open-close/debulking.