Cytoreductive surgery plus intraperitoneal chemohyperthermia in patients with colorectal cancer at high risk for local-regional recurrence.
This article was written to define the situations in which early second-look surgery with a combined treatment should be indicated in patients at high risk of developing peritoneal carcinomatosis (PC). Through a review of the literature, this is a definition of the second-look concept and of the different groups of patients at risk, in different situations (after resection of the primary, after initial cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy, and after the discovery of isolated carcinoembryonic antigen elevation or isolated peritoneal uptake on positron emission tomography scan). Systematic second-look surgery for early treatment of asymptomatic PC is probably beneficial in patients presenting a high risk of developing PC after resection of their primary. The benefit seems considerably lower for the other groups of high-risk patients.
Lefevre
Jeremie H
JH
Department of Oncologic Surgery, Institut Gustave Roussy, Villejuif, France.
Elias
Dominique M
DM
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*
D000970:Antineoplastic Agents