Peritoneal carcinomatosis.
Several gastrointestinal and gynecological malignancies have the potential to disseminate and grow in the peritoneal cavity. The occurrence of peritoneal carcinomatosis (PC) has been shown to significantly decrease overall survival in patients with liver and/or extraperitoneal metastases from gastrointestinal cancer. During the last three decades, the understanding of the biology and pathways of dissemination of tumors with intraperitoneal spread, and the understanding of the protective function of the peritoneal barrier against tumoral seeding, has prompted the concept that PC is a loco-regional disease: in absence of other systemic metastases, multimodal approaches combining aggressive cytoreductive surgery, intraperitoneal hyperthermic chemotherapy and systemic chemotherapy have been proposed and are actually considered promising methods to improve loco-regional control of the disease, and ultimately to increase survival. The aim of this review article is to present the evidence on treatment of PC in different tumors, in order to provide patients with a proper surgical and multidisciplinary treatment focused on optimal control of their locoregional disease.
Federico Coccolini, Marco Lotti, Luca Ansaloni, Department of General Surgery, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy.
Federico
F
Coccolini
Federico
F
Gheza
Marco
M
Lotti
Salvatore
S
Virzì
Domenico
D
Iusco
Claudio
C
Ghermandi
Rita
R
Melotti
Gianluca
G
Baiocchi
Stefano Maria
SM
Giulini
Luca
L
Ansaloni
Fausto
F
Catena
D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D005833:Genital Neoplasms, Female / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D016896:Treatment Outcome
Advanced; Cancer; Carcinosis; Colorectal; Cytoreductive surgery; Gastric; Hipec; Intraperitoneal chemotherapy; Ovarian; Peritoneal