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Early Postoperative Intraperitoneal Chemotherapy: Current Role and Future Perspectives

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Management of Peritoneal Metastases- Cytoreductive Surgery, HIPEC and Beyond

Abstract

The introduction of cytoreductive surgery and hyperthermic intraperitoneal perioperative chemotherapy has greatly improved the prognosis of patients with peritoneal carcinomatosis. In spite of these improvements, the majority of patients still die of intra-abdominal dissemination. Several strategies to consolidate and improve these results are being explored. The aim of this manuscript is to evaluate early postoperative intraperitoneal chemotherapy as a possible leverage point to further improve multimodal therapy of peritoneal carcinomatosis.

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Abbreviations

AUC:

Area under the curve

BIC:

Bidirectional intraoperative chemotherapy

CCR:

Completeness of cytoreduction

CRC:

Colorectal carcinoma

CRS:

Cytoreductive surgery

DMPM:

Diffuse malignant peritoneal mesothelioma

EPIC:

Early postoperative intraperitoneal chemotherapy

FU:

Fluorouracil

HIPEC:

Hyperthermic intraperitoneal perioperative chemotherapy

IPC:

Intraperitoneal chemotherapy

LV:

Leucovorin

MMC:

Mitomycin C

NA:

Not available

NIPS:

Neoadjuvant intraperitoneal and systemic chemotherapy

OS:

Overall survival

PCI:

Peritoneal carcinomatosis index

PFS:

Progression-free survival

PM:

Peritoneal metastases

SIPC:

Sequenced intraperitoneal chemotherapy

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Acknowledgements

Lemoine L. is supported by the Agency for Innovation by Science and Technology (IWT) in Brussels, Belgium. Lemoine L. is a researcher for the Limburg Clinical Research Program (LCRP) UHasselt-ZOL-Jessa, supported by the foundation Limburg Sterk Merk (LSM), Hasselt University, Ziekenhuis Oost-Limburg and Jessa Hospital, Belgium.

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  1. Department of Surgical Oncology, Ziekenhuis Oost-Limburg, Genk, Belgium

    T. Douchy, L. Lemoine & K. Van der Speeten

  2. Department of Biochemistry, Faculty of Medicine, University Hasselt, Diepenbeek, Belgium

    L. Lemoine & K. Van der Speeten

  3. Washington Cancer Institute, Washington Hospital Center, Washington, DC, USA

    K. Van der Speeten

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  1. Department of Surgical Oncology, Fortis Hospital, Bangalore, India

    Aditi Bhatt

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Douchy, T., Lemoine, L., Van der Speeten, K. (2018). Early Postoperative Intraperitoneal Chemotherapy: Current Role and Future Perspectives. In: Bhatt, A. (eds) Management of Peritoneal Metastases- Cytoreductive Surgery, HIPEC and Beyond. Springer, Singapore. https://doi.org/10.1007/978-981-10-7053-2_5

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