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Review
. 2016 Feb;7(1):143-57.
doi: 10.3978/j.issn.2078-6891.2015.112.

Cytoreductive surgery and intraperitoneal chemotherapy: an evidence-based review-past, present and future

Ahmed Dehal  1 , J Joshua Smith  1 , Garrett M Nash  1
Affiliations
Review

Cytoreductive surgery and intraperitoneal chemotherapy: an evidence-based review-past, present and future

Ahmed Dehal et al. J Gastrointest Oncol. 2016 Feb.

Abstract

Peritoneal carcinomatosis (PC) has historically been considered a terminal condition with merely palliative treatment achieving a survival rate measured in months. Cytoreductive surgery (CyRS) and intraperitoneal chemotherapy (IPC) have emerged as potentially effective regional treatments with the potential for long-term survival in well-selected patients. The fundamentals of CyRS and IPC are patient selection and complete cytoreduction. Since there is now sufficient evidence for the superiority of CyRS and IPC to systemic chemotherapy alone in a highly select group of patients, surgeons and oncologists should be aware of this modality as a potential benefit for patients with PC. The aim of this report is to highlight cancer-specific evidence in the context of ongoing studies regarding the outcome of this treatment.

Keywords: Cytoreductive surgery (CyRS); appendiceal mucinous neoplasms; colorectal cancer (CRC); early postoperative intraperitoneal chemotherapy (EPIC); gastric cancer; hyperthermic intraperitoneal chemotherapy (HIPEC); intraperitoneal chemotherapy (IPC); ovarian cancer and mixed types of peritoneal cancer (OC and mixed types of peritoneal cancer); peritoneal carcinomatosis (PC); peritoneal mesothelioma.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
ICARuS (Intraperitoneal Chemotherapy After CytoReductive Surgery) trial.
Figure 2
Figure 2
A phase II randomized study for outcomes after secondary cytoreductive surgery with or without carboplatin HIPEC followed by systemic combination chemotherapy for recurrent platinum-sensitive ovarian, fallopian tube or primary peritoneal cancer. Shown is the schema for the study. After 1st platinum sensitive recurrence is identified the patients will be randomized intra-operatively after all eligibility criteria are met. Each arm includes 49 patients and post-operatively the patients will receive 5 cycles of standard IV chemotherapy in the HIPEC arm or 6 cycles in the non-HIPEC arm. Courtesy of Dennis Chi, MD (with permission) (https://clinicaltrials.gov/ct2/show/NCT01767675). CyRS, cytoreductive surgery; HIPEC, hyperthermic intraperitoneal chemotherapy.
See this image and copyright information in PMC

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