[Cytoreductive surgery and HIPEC for peritoneal malignancies in children]

Area of Science:

• Oncology
• Surgical Oncology
• Pediatric Oncology

Context:

• Peritoneal tumour dissemination signifies advanced cancer with poor prognoses.
• Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved adult survival rates for peritoneal malignancies.
• While less common in children, peritoneal carcinomatosis/sarcomatosis can occur with specific pediatric cancers.

Purpose:

• To review the current indications for CRS and HIPEC in pediatric patients with peritoneal carcinomatosis/sarcomatosis.
• To outline established treatment regimens and potential challenges associated with CRS and HIPEC in children.
• To highlight CRS and HIPEC as a novel treatment modality in select pediatric oncology centers.

Summary:

• CRS and HIPEC, a treatment combining surgery with heated chemotherapy, is an established approach for adults with peritoneal tumors, significantly improving survival.
• In pediatric oncology, CRS and HIPEC is an emerging treatment for peritoneal carcinomatosis/sarcomatosis, seen in conditions like desmoplastic small round cell tumors and sarcomas.
• This review examines the application, protocols, and difficulties of CRS and HIPEC in the pediatric population.

Impact:

• Establishes CRS and HIPEC as a viable, albeit novel, treatment for pediatric peritoneal carcinomatosis/sarcomatosis.
• Provides a framework for understanding the indications and management of this complex condition in children.
• Aims to improve outcomes for pediatric patients facing advanced peritoneal malignancies.