REVIEW – October 2009

Combination of cytoreductive surgery and intraperitoneal chemotherapy in management of peritoneal carcinomatosis

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Abstract

Peritoneal tumour dissemination arising from gastrointestinal or gynecologic malignancies is a common sign of advanced tumour stage or disease recurrence, mostly associated with poor prognosis. Selection of potentially curative treatment opportunities is extremely limited. Improvements in surgical techniques, intensive care and chemotherapy have provided a combination of two local aggressive treatment methods – cytoreductive surgery and intraperitoneal chemotherapy – for selected patients, which can improve survival  compared with palliation or supportive care.

Over the years the feasibility, efficacy and safety of this promising combination have been proved in numerous clinical trials. A new trend has been developed toward the use of this method as a standard for treating several peritoneal tumours in multimodal cancer centres. In the present review article a brief history, indications, principles of patient selection, treatment strategies, complications and outcomes are reported regarding the different tumour entities.