The many faces of intraperitoneal chemotherapy

Area of Science:

• Surgical Oncology
• Medical Oncology

Background:

• Peritoneal metastasis presents a complex challenge in surgical oncology.
• Cytoreductive surgery (CRS) combined with intraperitoneal chemotherapy (IPC) offers a potential cure for patients with peritoneal metastasis.
• Significant variability exists in the current management protocols, leading to uncertainty in treatment selection.

Purpose of the Study:

• To review the variability in the management of peritoneal metastasis.
• To raise awareness regarding treatment variations in CRS and IPC.
• To initiate efforts towards standardizing this treatment combination.

Main Methods:

• Comprehensive review of variations in CRS and IPC for peritoneal metastasis.
• Analysis of differences in indications, patient selection, extent of CRS, and IPC regimens.
• Evaluation of treatment outcomes across different tumor types.

Main Results:

• Best outcomes observed in pseudomyxoma peritonei, followed by colorectal, ovarian, and gastric cancers.
• Indications for CRS and IPC are expanding to include other tumor pathologies.
• Variability noted in patient selection criteria, surgical resection extent, and chemotherapy administration methods.

Conclusions:

• Reducing variance in CRS and IPC protocols is essential for optimizing patient benefit.
• Development of practical guidelines is needed to establish CRS and IPC as a standard of care.
• Further standardization will facilitate wider adoption and improve outcomes for peritoneal metastasis.