[Cytoreductive surgery for malignant peritoneal tumors]

Area of Science:

• Surgical Oncology
• Gastroenterology
• Oncology

Context:

• Peritoneal metastases require a multimodal treatment approach.
• Cytoreductive surgery is a cornerstone of this strategy.
• Indications include primary peritoneal tumors and secondary spread from various cancers.

Purpose:

• To outline the indications and critical factors for patient selection in cytoreductive surgery for peritoneal malignancies.
• To emphasize the importance of complete macroscopic cytoreduction and standardized surgical techniques.
• To highlight the necessity of specialized expertise and centers for optimal patient outcomes.

Summary:

• Cytoreductive surgery is vital for treating peritoneal metastases from tumors such as mesothelioma, colorectal cancer, and pseudomyxoma peritonei.
• Patient selection hinges on tumor type, load, and distribution.
• Complete macroscopic cytoreduction, achieved via peritonectomy, is the strongest prognostic factor.
• Standardized procedures performed by experienced surgical oncologists in specialized centers are crucial.

Impact:

• Optimizing patient selection and surgical technique can improve outcomes for peritoneal malignancies.
• Centralizing treatment in specialized centers reduces morbidity and mortality.
• Documentation in registries like HIPEC facilitates ongoing research and quality improvement.