HIPEC in controversial digestive tumors

Area of Science:

• Surgical Oncology
• Gastrointestinal Oncology
• Medical Oncology

Background:

• Local-regional and peritoneal metastases remain a challenge despite surgical advancements.
• Intraperitoneal chemotherapy has demonstrated efficacy in reducing metastases across various malignancies.
• Perioperative intraperitoneal chemotherapy following aggressive resection shows promise for digestive system tumors.

Purpose of the Study:

• To evaluate the effectiveness of intraperitoneal chemotherapy in preventing local-regional and peritoneal metastases.
• To assess the survival benefits and recurrence rates associated with this treatment modality.

Main Methods:

• Review of prospective trials and meta-analyses.
• Analysis of data from patients with locally advanced gastric, colorectal, and pancreatic carcinomas.

Main Results:

• Significant survival benefits observed in gastric and colorectal cancer patients receiving surgery with perioperative intraperitoneal chemotherapy.
• Reduced local-regional metastases rates in these patient groups.
• Preliminary positive results in pancreatic cancer patients treated with R0 resection and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC), showing no local-regional recurrences.

Conclusions:

• Perioperative intraperitoneal chemotherapy is a valuable strategy for reducing metastases and improving survival in locally advanced digestive cancers.
• Hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) shows potential for preventing local-regional recurrences in pancreatic cancer.
• Further research is warranted to confirm these findings and optimize treatment protocols.