Hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis of digestive and peritoneal origin: rationale.

Up to a few years ago peritoneal carcinomatosis was considered as an "incurable" disease. The aim of this paper is to review the surgical approach with curative intent to carcinomatosis: it consists of complete resection of macroscopic disease (R1), associated with hyperthermic intraperitoneal chemotherapy (HIPEC) to treat residual microscopic disease, and to evaluate its indications. Overall 5-year survival of patients with peritoneal carcinomatosis treated by HIPEC is similar to that of patients with hepatic metastases treated with curative intent. Those patients should no longer be considered as patients with a terminal disease but as patients with a potentially treatable localized disease.

[Surgical treatment of peritoneal carcinomatosis]. / Traitement chirurgical des carcinoses péritonéales: 2--la chimiohyperthermie.

Surgical treatment of peritoneal carcinomatosis with curative intent involves the resection of all macroscopic malignant tissue and the treatment of microscopic residual tissue with local chemotherapy. Intraperitoneal chemotherapy is efficient only when associated with hyperthermia. This article details the technical aspect of intraperitoneal chemohyperthermia. These techniques involve specific and important features. At these conditions, peritoneal carcinomatosis can be cured in two-thirds of cases.