Copyright ©The Author(s) 2016.
World J Gastrointest Oncol. Jan 15, 2016; 8(1): 67-82
Published online Jan 15, 2016. doi: 10.4251/wjgo.v8.i1.67
Table 1 Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy median survival, related to the tumor entities and study type
Primitive tumor originStudy typeMedian survival (mo)
ColorectalRandomized clinical trials22.3[35]
Single center experience33[53], 34.7[45]
Systematic reviews13-29[54]
Multi-institutional studies33[52]
GastricRandomized clinical trials11.3[46], 11[47]
Pseudomyxoma peritoneiSingle center experience104[53]
Multi-institutional studies130[52]
OvarianMulti-institutional studies35.4-45.7[51]
Systematic reviews22-54[55]
Malignant peritoneal mesotheliomaSystematic reviews34-92[56]
Table 2 Key aspects and peritoneal metastases model in the evolution of multimodal treatment
PeriodPM treatmentKey aspectsPM model
All the period“Conventional” systemic chemotherapySignificant lower survival for PM vs other type of metastasesColo-rectal
1950-1980“Dedicated” intraperitoneal treatment - Palliative treatmentThe basis for developing further cytostatic drugsMalignant ascites
1980-2000“Dedicated” intraperitoneal treatment - Multimodal radical treatmentRegional intraperitoneal normothermic and hyperthermic chemotherapyAppendicular
Peritonectomy procedures
Define PCI and CCRS
2000-2010Multimodal radical treatment - confirmation, aspects, patient selection, controversiesSignificant higher survival vs palliative surgery and diverse systemic chemotherapy regimesColo-rectal
Acceptable morbidity and mortality, no significant risk for medical teamAppendicular
Respect de learning curvePseudomyxoma peritonei
High costsMalignant peritoneal mesothelioma
Define the prognostic factorsGastric
Position of oncologistsOvarian
Comparison with hepatic metastasesPM with hepatic metastases
2010-2014Multimodal treatment – research pathwaysPM prophylaxisHigh-risk patients for developing PM
Laparoscopic HIPECRecurrent PM
Integration of chemotherapy with surgery
Extension of CRS