38IN - When to think of surgery plus or minus HIPEC for peritoneal carcinomatosis

Date 30 September 2012
Event ESMO Congress 2012
Session Pursuing the NED condition in stage IV colorectal cancer
Topics Colon Cancer
Rectal Cancer
Surgery and/or Radiotherapy of Cancer
Presenter Dominique Elias
Authors D. Elias
  • Department Of Surgical Oncology, Institut Gustave Roussy, 94805 - Villejuif/FR

Abstract

The occurrence of PC considerably worsens the prognosis of cancers. The classic treatment yields an overall survival of below 5% at 5years. However, in 20% of the cases, the disease is exclusively peritoneal, and a treatment combining complete cytoreductive surgery (CCRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has made it possible to achieve a major increase in 5-year overall survival. HIPEC is only proposed for treating residual infra-millimetric,PC and therefore, is logical and useful exclusively after CCRS. The current appropriate indications are as follows: For peritoneal pseudomyxomas (5-year OSR is above 80%). For colorectal PC (5-year OSR exceed 40%, with 18% of patients definitively cured). For mesotheliomas (the 5-year OSR is close to 58%) Current doubtful indications are as follows: For gastric tumours (the 5-year OSR is close to 15%). For ovarian cancers (OSR are very low when CCRS + HIPEC is used as a salvage treatment). For few rare PC (not detailed).

Conclusion

CCRS + HIPEC are the current gold standard therapy for peritoneal extension of pseudomyxoma, mesotheliomas and colorectal PC, for selected patients.

Disclosure

The author has declared no conflicts of interest.