Peritoneal carcinomatosis from unusual cancer origins: Is there a role for hyperthermic intraperitoneal chemotherapy?

Abstract

The decision to perform CCRS plus HIPEC for PC arising from unusual cancer origins remains difficult. These patients should be prospectively entered into registries of rare tumors that involve the peritoneum in order to better define indications.

Complete cytoreductive surgery plus HIPEC for peritoneal metastases from unusual cancer sites of origin: results from a worldwide analysis issue of the Peritoneal Surface Oncology Group International (PSOGI)

“…In those cases, indications for CRS and HIPEC are exceptional because most of the time PM are associated with extra-peritoneal dissemination. However, there are also abdominal malignancies with a known major peritoneal tropism that may benefit from CRS and HIPEC but whose rarity is such that their description in the literature does not exceed sporadic clinical case reports [13]. Consequently, the efficacy of CRS followed by HIPEC for patients with non-colorectal PM and non-primary peritoneal malignancies remains unclear because of the heterogeneity of primary tumour types, and the limited number of patients reported.…”

Breast cancer with intraabdominal metastases. Is surgery necessary?

“…There are no randomized studies demonstrating the advantages of the excision of intraabdominal metastases derived from BC in comparison with chemotherapy alone. However, MBC patients with single liver metastases can become candidates for metastasectomy [8]. There are several publications attesting an increase in survival among patients with isolated hepatic metastases from BC who underwent hepatic resections.…”

“…Patients with primary metastatic diseases have poorer prognosis and benefit less from hepatectomy than those in whom liver metastasis occur more than one year after breast cancer diagnosis [5,8,9]. Despite related criteria of selection of the candidates for hepatectomy in MBC, a few single institution studies report favorable initial results in patients with more than one liver metastases, and more than that, even perform re-resection of hepatic metastases derived from BC [10,11].…”

Ninety percent of the adverse outcomes occur in 10% of patients: can we identify the populations at high risk of developing peritoneal metastases after curative surgery for colorectal cancer?

“…This could lead to either a prophylactic HIPEC or a "2nd look" surgery to these selected patients. Other risk factor have been identified in other histological subtype, like the loss of heterozygosity in chromosome 18 in neuroendocrine tumour or tumour rupture in abdominal soft tissue sarcoma, but we have no sufficiently efficient locoregional treatment to discuss any aggressive proactive management [31].…”