title: Hyperthermic Intraperitoneal Chemotherapy and Cytoreductive Surgery in the Management of Peritoneal Carcinomatosis.
abstract: BACKGROUND
  Malignant peritoneal disease can lead to significant debility due to bowel obstructions, ascites, and cancer cachexia. Moreover, inadequate imaging techniques can lead to the suboptimal detection of disease, and the poor vascularity of tumors can lead to a poor response to systemic chemotherapy. However, combination cytoreductive surgery/hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising novel treatment for patients with this disease.
  
  
  METHODS
  The medical literature focusing on diagnostic updates and the management of peritoneal disease was reviewed. The application principles of HIPEC for use in peritoneal disease were also summarized.
  
  
  RESULTS
  Improvements in imaging and the application of laparoscopic techniques have significantly increased the rate of diagnosis of early peritoneal disease with consequently less morbid cytoreductive procedures. Appropriate patient selection based on prognostic scores along with complete cytoreduction can identify a cohort of patients likely to derive durable benefit from this combination treatment.
  
  
  CONCLUSIONS
  Advances in diagnostic and therapeutic techniques, including surgical cytoreductive techniques, have demonstrated significant survival gains in patients with peritoneal disease. Although HIPEC can be used for the management of various types of histologies, further development of high-level evidence is necessary to advance the field.
authors.forename: Rahul
authors.initials: R
authors.lastname: Rajeev
authors.affiliation: Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. kturaga@mcw.edu.
authors.forename: Kiran K
authors.initials: KK
authors.lastname: Turaga
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000601:surgery / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents