title: Multimodality treatment strategies have changed prognosis of peritoneal metastases.
abstract: For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with "terminal status/despair". The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams.
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Corneliu
authors.initials: C
authors.lastname: Lungoci
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Aurel Ion
authors.initials: AI
authors.lastname: Mironiuc
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Valentin
authors.initials: V
authors.lastname: Muntean
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Traian
authors.initials: T
authors.lastname: Oniu
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Hubert
authors.initials: H
authors.lastname: Leebmann
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Max
authors.initials: M
authors.lastname: Mayr
authors.affiliation: Corneliu Lungoci, Aurel Ion Mironiuc, Valentin Muntean, Traian Oniu, Department of Surgery, "Iuliu Htieganu" University of Medicine and Pharmacy Cluj-Napoca, 400015 Cluj-Napoca, Cluj Province, Romania.
authors.forename: Pompiliu
authors.initials: P
authors.lastname: Piso
keywords: Hyperthermic intraperitoneal chemotherapy; Peritoneal metastases; Peritonectomy procedures; Survival; Systemic chemotherapy