Editorial
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Oct 14, 2012; 18(38): 5317-5320
Published online Oct 14, 2012. doi: 10.3748/wjg.v18.i38.5317
Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Where are we?
Ingmar Königsrainer, Stefan Beckert
Ingmar Königsrainer, Stefan Beckert, Department of General, Visceral and Transplant Surgery, Tübingen University Hospital, D-72076 Tübingen, Germany
Author contributions: Königsrainer I prepared the first draft and designed the editorial; Beckert S designed the editorial and revised the manuscript; both authors performed the literature search and approved the final manuscript.
Correspondence to: Ingmar Königsrainer, MD, Department of General, Visceral and Transplant Surgery, Tübingen University Hospital, Hoppe-Seyler-str. 3, D-72076 Tübingen, Germany. ingmar.koenigsrainer@med.uni-tuebingen.de
Telephone: +49-7071-2985073 Fax: +49-7071-295588
Received: March 19, 2012
Revised: June 6, 2012
Accepted: July 9, 2012
Published online: October 14, 2012
Abstract

Peritoneal surface malignancies are generally associated with poor prognosis. In daily clinical routine, systemic chemotherapy is still considered the only reasonable therapy despite of encouraging results of cytoreductive surgery (CRS) along with intraperitoneal hyperthermic chemotherapy (HIPEC). The Achilles heel of CRS and HIPEC is appropriate patient selection and precise surgical technique preventing patients from excessive morbidity and mortality. Given these findings, new concepts of second look surgery for high risk patients allow detection of peritoneal spread ahead of clinical symptoms or presence of peritoneal masses reducing perioperative morbidity. In addition, personalized intraperitoneal chemotherapy might further improve outcome by appreciating individual tumor biology. These days, every physician should be aware of CRS and HIPEC for treatment of peritoneal surface malignancies. Since there is now sufficient data for the superiority of CRS and HIPEC to systemic chemotherapy in selected patients, our next goal should be providing this strategy with minimal morbidity and mortality even in the presence of higher tumor load.

Keywords: Peritoneal carcinomatosis; Hyperthermic intraperitoneal chemotherapy; Cytoreductive surgery