Cure for peritoneal metastases? An evidence-based review

ANZ J Surg. 2013 Nov;83(11):821-6. doi: 10.1111/ans.12306. Epub 2013 Jul 1.

Abstract

There is now a considerable body of published evidence supporting the use of a multimodal approach consisting of cytoreductive surgery (CS) and heated intraperitoneal chemotherapy (HIPEC) in the treatment of peritoneal metastases (PM) arising from selected gastrointestinal tract malignancies. In the absence of systemic metastases, it is thought that disease confined to the peritoneum may be eradicated through optimum cytoreduction. This review critically evaluates the current body of published evidence for the use of CS/HIPEC in the treatment of advanced colorectal, appendiceal and gastric cancer. Although its role remains less defined in patients with gastric PM, current evidence provides a compelling argument for its use in PM of colorectal and appendiceal origin. With a low mortality and acceptable morbidity rate, CS/HIPEC may offer hope of long-term survival and cure in a defined group of patients with this disease.

Keywords: colorectal surgery; surgical oncology.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Appendiceal Neoplasms / pathology*
  • Appendiceal Neoplasms / therapy
  • Chemotherapy, Cancer, Regional Perfusion
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / therapy
  • Evidence-Based Medicine
  • Humans
  • Hyperthermia, Induced / methods*
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / surgery
  • Peritoneal Neoplasms / therapy*
  • Peritoneum / surgery
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy
  • Treatment Outcome

Substances

  • Antineoplastic Agents