Peritoneal cancer treatment

Abstract

Introduction: In the past, peritoneal surface malignancy (PSM) was considered as a final stage of cancer, and patients were offered the best supportive care. Recently, a new therapeutic alternative approach based on the combination of surgery with chemotherapy was developed. In this curative intent, the macroscopic disease was treated with cytoreductive surgery (CRS) combined with perioperative chemotherapy, including neoadjuvant chemotherapy, hyperthermic intraoperative intraperitoneal chemotherapy, extensive intraoperative peritoneal lavage and early postoperative intraperitoneal chemotherapy

Areas covered: This article reviews the mechanisms of the formation of PSM, quantitative estimation of PSM and residual disease, multimodal treatment, value of laparoscopy, prognostic factors and patients' selection for the multimodal therapy.

Expert opinion: Recent studies show that CRS plus intraperitoneal chemotherapy applications confer prolonged survival in patients with PSM from colorectal, gastric, ovarian, appendiceal mucinous carcinoma and diffuse malignant peritoneal mesothelioma. The comprehensive treatment is now justified as state-of-the-art for patients with peritoneal metastasis.

Keywords::

• cytoreductive surgery
• hyperthermic intraoperative intraperitoneal chemotherapy
• laparoscopic hyperthermia
• neoadjuvant chemotherapy
• peritoneal metastasis
• peritonectomy

Declaration of interest

The author has no relevant affiliations of financial involvement with any organization or entry with a financial interest in or financial conflict with subject matter or materials discussed in the manuscript.

Notes

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