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Journal of Gastrointestinal Surgery

Published in:

01-01-2021 | Surgery | Review Article

The Role of Hyperthermic Intraperitoneal Chemotherapy for Non-colorectal Peritoneal Surface Malignancies

Authors: Mackenzie C. Morris, Jordan M. Cloyd, John Hays, Sameer H. Patel

Published in: Journal of Gastrointestinal Surgery | Issue 1/2021

Abstract

Background

Peritoneal carcinomatosis, from a variety of gastrointestinal and gynecological malignancies, has been historically challenging to treat and there remains a wide range of biologic aggressiveness in these patients. Malignancies commonly associated with PC include those of colorectal, appendiceal, gastric, ovarian, sarcoma, small intestinal, and primary peritoneal origin among others. Advances in our understanding of this unique disease process have led to significant interest in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) as an emerging treatment option. The goal of CRS-HIPEC is to remove all visible macroscopic disease while preserving organ function, and then treat microscopic disease through perfusion of the peritoneal cavity with heated chemotherapy.

Purpose

Although recent reviews have focused on the management of peritoneal carcinomatosis secondary to colorectal cancer given the publication of several recent randomized controlled trials, the purpose of the current review is to summarize the evidence on CRS-HIPEC for non-colorectal peritoneal surface malignancies, including appendiceal neoplasms, malignant peritoneal mesothelioma, gastric cancer, and ovarian cancer.

Results

While retrospective studies have clarified the importance of prognostic factors such as the peritoneal carcinomatosis index, completeness of cytoreduction, histopathological characteristics, and lymph node positivity, the lack of convincing level 1 evidence for the use of CRS-HIPEC has led to it remaining a highly controversial topic.

Conclusion

The decision to utilize CRS-HIPEC should involve a multidisciplinary team approach and evaluation of prognostic factors to balance the short-term morbidity of the operation with maximum long-term benefits. Large, multi-institutional groups and ongoing trials hold promise for clarifying the role of CRS-HIPEC in peritoneal surface malignancies.

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Title: The Role of Hyperthermic Intraperitoneal Chemotherapy for Non-colorectal Peritoneal Surface Malignancies
Authors: Mackenzie C. Morris
Jordan M. Cloyd
John Hays
Sameer H. Patel
Publication date: 01-01-2021
Publisher: Springer US
Keywords: Surgery
Ovarian Cancer
Ovarian Cancer
Gastric Cancer
Gastric Cancer
Peritoneal Cancer
Peritoneal Carcinomatosis
Mesothelioma
Cytostatic Therapy
Published in: Journal of Gastrointestinal Surgery / Issue 1/2021
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-020-04771-8

At a glance: The STEP trials

Springer Medicine

The Role of Hyperthermic Intraperitoneal Chemotherapy for Non-colorectal Peritoneal Surface Malignancies

Abstract

Background

Purpose

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Results

Conclusion

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