Multimodality treatment strategies have changed prognosis of peritoneal metastases  

作　　者：corneliu lungoci aurel ion mironiuc valentin muntean traian oniu hubert leebmann max mayr pompiliu piso 

机构地区：[1]department of surgery,"iuliu htieganu"university of medicine and pharmacy cluj-napoca,400015 Cluj-Napoca,Cluj Province,Romania [2]clinic of visceral and general surgery,krankenhaus barmherzige brueder,academic teaching hospitals of the university regensburg,Bavaria Province,Germany

出　　处：《World Journal of Gastrointestinal Oncology》2016年第1期67-82,共16页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：For a long time, treatment of peritoneal metastases(PM) was mostly palliative and thus, this status was link with "terminal status/despair". The current multimodal treatment strategy, consisting of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources(multi-center and-institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results(similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams.For a long time, treatment of peritoneal metastases(PM) was mostly palliative and thus, this status was link with 'terminal status/despair'. The current multimodal treatment strategy, consisting of cytoreductive surgery(CRS) and hyperthermic intraperitoneal chemotherapy(HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources(multi-center and-institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results(similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists' perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams.

关 键 词：Hyperthermic INTRAPERITONEAL CHEMOTHERAPY PERITONECTOMY procedures Systemic CHEMOTHERAPY PERITONEAL METASTASES Survival 

分 类 号：R730.5[医药卫生—肿瘤]