Peritoneal-based malignancies and their treatment.
BACKGROUND
Patients with peritoneal carcinomatosis (PC) usually have dismal prognoses, even with traditional systemic therapy. Peritonectomy or cytoreductive surgery (CRS) has been used to treat selected patients. It is also commonly used in the management of pseudomyxoma peritonei (PMP), often in combination with hyperthermic intraperitoneal chemotherapy (HIPEC).


RESULTS
In the present review article, the indications for CRS and HIPEC are examined, along with its technical aspects, resulting morbidity and mortality. Patients with documented peritoneal carcinomatosis from colorectal and ovarian cancer or PMP, absence of extra-abdominal metastases and liver parenchymal metastases and with an ECOG performance status of <2 should be considered for CRS and HIPEC.


CONCLUSIONS
It is important to recognise the role of and indications for CRS and HIPEC. Biologic factors of the disease and completeness of resection are important prognostic factors. Cytoreductive surgery, combined with intraperitoneal chemotherapy, can improve survival in selected patients with peritoneal-based malignancies.
Teo
Melissa
M
Department of Surgical Oncology, National Cancer Centre of Singapore, Singapore. melteo1@gmail.com
D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D016019:Survival Analysis