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Review
. 2022 May 18;11(10):2840.
doi: 10.3390/jcm11102840.

Current Trends in Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Disease from Appendiceal and Colorectal Malignancies

Megan M Harper  1 , Joseph Kim  1 , Prakash K Pandalai  1
Affiliations
Review

Current Trends in Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Peritoneal Disease from Appendiceal and Colorectal Malignancies

Megan M Harper et al. J Clin Med. .

Abstract

Peritoneal carcinomatosis (PC) is a poor prognostic factor for all malignancies. This extent of metastatic disease progression remains difficult to treat with systemic therapies due to poor peritoneal vascularization resulting in limited drug delivery and penetration into tissues. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are surgical interventions that directly target peritoneal tumors and have improved outcomes for PC resulting from appendiceal and colorectal cancer (CRC). Despite these radical therapies, long-term survival remains infrequent, and recurrence is common. The reasons for these outcomes are multifactorial and signal the need for the continued development of novel therapeutics, techniques, and approaches to improve outcomes for these patients. Here, we review landmark historical studies that serve as the foundation for current recommendations, recent discoveries, clinical trials, active research, and areas of future interest in CRS/HIPEC to treat PC originating from appendiceal and colorectal malignancies.

Keywords: appendiceal cancer; colorectal cancer; cytoreductive surgery (CRS); hyperthermic intraperitoneal chemotherapy (HIPEC); peritoneal carcinomatosis; peritoneal surface malignancies (PSM).

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Conflict of interest statement

J.K. has received funding from Ipsen for research related to clinical trial NCT04088786. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. All other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Alternate Intraperitoneal Chemotherapy Treatment Modalities. Although HIPEC is the current standard-of-care intraperitoneal chemotherapy treatment option for PC from appendiceal and colorectal malignancies, other intraperitoneal chemotherapy treatment strategies are under investigation. NIPS (neoadjuvant intraperitoneal and systemic chemotherapy), PIPAC (pressurized intraperitoneal aerosol chemotherapy), HIPEC (hyperthermic intraperitoneal chemotherapy), NIPEC (normothermic intraperitoneal chemotherapy), EPIC (early postoperative intraperitoneal chemotherapy).
See this image and copyright information in PMC

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