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World J Gastrointest Oncol. Dec 15, 2011; 3(12): 169-174
Published online Dec 15, 2011. doi: 10.4251/wjgo.v3.i12.169
Rationale and techniques of cytoreductive surgery and peritoneal chemohyperthermia
Antonio Macrì, Anna Fortugno, Edoardo Saladino
Antonio Macrì, Anna Fortugno, Edoardo Saladino, Department of Human Pathology, General Surgery Unit, University of Messina, 98125 Messina, Italy
Author contributions: All authors contributed to this paper
Correspondence to: Antonio Macrì, MD, Professor, Department of Human Pathology, General Surgery Unit, University of Messina, Via Consolare Valeria, 98125 Messina, Italy. amacri@unime.it
Telephone: +39-90-2212678 Fax: +39-90-2212683
Received: May 5, 2011
Revised: October 29, 2011
Accepted: November 8, 2011
Published online: December 15, 2011

The evolution of loco-regional treatments has occurred in the last two decades and has deeply changed the natural history of primitive and secondary peritoneal surface malignancies. Several phase II-III studies have proved the effectiveness of the combination of cytoreductive surgery with peritoneal chemohyperthermia. Cytoreductive surgery allows the reduction of the neoplastic mass and increases tumoral chemosensitivity. The development of chemohyperthermia finds its origins in the necessity to exceed the limits of intraperitoneal chemotherapy performed in normothermia. It permits a continuous high concentration gradient of chemotherapeutic drugs between the peritoneal cavity and the plasma compartment to and a more uniform distribution throughout the abdominal cavity compared to systemic administration.

Keywords: Hyperthermic intraperitoneal chemotherapy, Peritoneal surface malignancies, Peritoneal carcinomatosis, Cytoreductive surgery, Loco-regional treatments