Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in gastrointestinal cancers: fad or standard of care?
- Author:
Melissa Ching Ching TEO
1
;
Grace Hwei Ching TAN
1
Author Information
- Publication Type:Journal Article
- Keywords: CRS; HIPEC; peritoneal metastases
- MeSH: Colorectal Neoplasms; pathology; Combined Modality Therapy; Cytoreduction Surgical Procedures; Gastrointestinal Neoplasms; pathology; Humans; Hyperthermia, Induced; Intestinal Neoplasms; pathology; Peritoneal Neoplasms; secondary; therapy; Peritoneum; Standard of Care
- From:Singapore medical journal 2018;59(3):116-120
- CountrySingapore
- Language:English
- Abstract: Peritoneal metastases (PM) are the common endpoint for patients with advanced gastrointestinal cancers. PM from these cancers are often managed in a similar fashion to other sites of systemic metastases, but the following must be taken into consideration. (a) PM do not respond to systemic chemotherapy in the same fashion as liver and lung metastases. (b) PM cause local problems, resulting in disruption of chemotherapy. (c) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) actually work for PM. (d) PM are not easily detected on imaging modalities. There has been mounting evidence of the effectiveness of CRS-HIPEC at prolonging survival in selected patients with colorectal and gastric PM, but there remains a reluctance to explore this treatment modality. This is likely because of the perceived morbidity and mortality. An effective management strategy employing CRS-HIPEC for selected patients with gastrointestinal PM can only be achieved if a concerted effort is made to understand this disease and address the concerns regarding this treatment.
