Abstract
BackgroundPeritoneal tumor dissemination arising from colorectal cancer, appendiceal cancer, gastric cancer, gynecologic malignancies or peritoneal mesothelioma is a common sign of advanced tumor stage or disease recurrence and mostly associated with poor prognosis.Methods and resultsIn the present review article preoperative workup, surgical technique, postoperative morbidity and mortality rates, oncological outcome and quality of life after CRS and HIPEC are reported regarding the different tumor entities.ConclusionCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) provide a promising combined treatment strategy for selected patients with peritoneal carcinomatosis that can improve patient survival and quality of life. The extent of intraperitoneal tumor dissemination and the completeness of cytoreduction are the leading predictors of postoperative patient outcome. Thus, consistent preoperative diagnostics and patient selection are crucial to obtain a complete macroscopic cytoreduction (CCR-0/1).
Highlights
Peritoneal tumor dissemination arising from colorectal cancer, appendiceal cancer, gastric cancer, gynecologic malignancies or peritoneal mesothelioma is a common sign of advanced tumor stage or disease recurrence and mostly associated with poor prognosis
Peritoneal carcinomatosis is a common sign of advanced tumor stage, disease progression or recurrence in numerous tumor entities of gastrointestinal or gynecological origin
The existing studies show that Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can be performed with acceptable postoperative quality of life (QoL) and even may improve QoL in a selected part of long-term survivors
Summary
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy provide a promising therapeutic option for highly selected patients with peritoneal carcinomatosis arising from different malignancies such as colorectal cancer, gastric cancer, ovarian cancer or peritoneal mesothelioma. Numerous studies with different levels of evidence have shown that the integration of CRS and HIPEC in an interdisciplinary treatment concept may improve the oncological outcome compared to sole palliative systemic chemotherapy. For most tumor entities prospective randomized controlled trials comparing best available therapy using new therapeutic agents and combined systemic chemotherapy with and without CRS and HIPEC are still not available. Such studies may provide higher levels of evidence in the future and help to determine the significance of CRS and HIPEC as an integrative part of an interdisciplinary cancer treatment strategy in selected patients with peritoneal carcinomatosis
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