Treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: State of the art and future developments

Feasibility of Delayed Hyperthermic Intraperitoneal Chemotherapy in Case of Unforeseen Complications

“…All patients underwent a comprehensive preoperative evaluation including physical examination, blood tests, chest X-ray, echocardiography, spirometry and staging with abdominal ultrasonography and positron emission tomography combined with computed tomography. CRS combined with HIPEC was indicated in patients meeting the following inclusion criteria according to previously published selection criteria [20,21,22,23]: age >16 and <80 years, abdominal cancer patients with malignant peritoneal mesothelioma as well as pseudomyxoma peritonei, PC confirmed by pathologic examination, synchronous or metachronous PC, absence of extra-abdominal metastases, no liver metastases on preoperative explorations, satisfactory cardiorespiratory and renal status, and signed informed consent. Exclusion criteria were age <16 or >80 years, unresectable primary tumors, unresectable distant disease involving the liver, lymph node involvement beyond regional draining groups or other distant sites of disease and/or active second malignancy regardless of the site.…”

Abdominal Advanced Oncologic Surgery

“…Results after treatment are encouraging in particular in cases of colorectal and gynaecological cancer with median 5 years survival respectively of 40% and 45%. Less satisfactory results have been obtained in case of gastric and pancreatic cancer with a minimal percentage of patient still living far from initial diagnosis (Elias et al, 2006;Roviello et al, 2011). The aggressive tumour surgical removal (tumour cytoreduction) coupled with intraperitoneal chemotherapy nowadays represents the cornerstone of advanced abdominal oncologic surgery Glockzin et al, 2009).…”

“…The aggressive tumour surgical removal (tumour cytoreduction) coupled with intraperitoneal chemotherapy nowadays represents the cornerstone of advanced abdominal oncologic surgery Glockzin et al, 2009). A large international experience was therefore made through the last decades with the goal of allowing treatment and possibly cure of intraperitoneal tumours in advanced stage (Levine et al, 2007;Roviello et al, 2011). …”

“…According to several phase I and II prospective trials, 5-year survivals have ranged between 66% and 97% (Stewart et al, 2005). It must be taken in mind that, because of the limited data on prognostic factors for this procedure in the setting of appendiceal primary tumors, further well designed, prospective, multi-institutional study are required (Bevan et al, 2010;Roviello et al, 2011).…”

The implementation of randomized trials in the treatment of advanced ovarian cancer with HIPEC: waiting for new evidence

“…The hyperthermicintraperitoneal chemotherapy (HIPEC) proved its capability to prolong both OS and DFS in many other different pathologies such as colon and gastric cancer, pesudomixomaperitonei and peritoneal mesothelioma [1]. Many phase I and II studies in the use of HIPEC in OC showed that it is related to positive results and an acceptable morbidity rate [2].…”