Erschienen in:
01.08.2018 | Gastrointestinal Cancers (J Meyer, Section Editor)
Peritoneal Metastases from Gastrointestinal Cancer
verfasst von:
Paul H. Sugarbaker
Erschienen in:
Current Oncology Reports
|
Ausgabe 8/2018
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Abstract
Purpose of Review
Peritoneal metastases may occur from a majority of cancers that occur within the abdomen or pelvis. When cancer spread to the peritoneal surfaces is documented, a decision regarding palliation vs. an aggressive approach using cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy must be made. The perioperative chemotherapy may be hyperthermic intraperitoneal chemotherapy (HIPEC) administered in the operating room or early postoperative intraperitoneal chemotherapy (EPIC) administered in the first 4 or 5 postoperative days.
Recent Findings
This decision is dependent on a well-defined group of prognostic indicators. In addition to treatment, the clinical and pathologic features of a primary cancer can be used to select perioperative treatments that may prevent cancer cells within the abdomen and pelvis from progressing to established peritoneal metastases. In some clinical situations with appendiceal and colorectal cancers, the clinical or histopathologic features may indicate that second-look surgery plus perioperative chemotherapy should occur.
Summary
Peritoneal metastases should always be considered for treatment or prevention.