Early postoperative intraperitoneal chemotherapy for lower gastrointestinal neoplasms with peritoneal metastasis: a systematic review and critical analysis
| Autor: | Mikael L. Soucisse, Gabrielle Hicks, David L. Morris, Winston Liauw |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Peritoneal metastasis
medicine.medical_specialty Colorectal cancer Review EPIC Gastroenterology 03 medical and health sciences 0302 clinical medicine Peritonectomy Internal medicine Internal Medicine Medicine HIPEC business.industry appendiceal cancer peritoneal carcinomatosis Intraperitoneal chemotherapy medicine.disease Peritoneal carcinomatosis peritonectomy colon cancer 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Hyperthermic intraperitoneal chemotherapy business Cytoreductive surgery |
| Zdroj: | Pleura and Peritoneum |
| ISSN: | 2364-768X |
| Popis: | BackgroundEarly postoperative intraperitoneal chemotherapy (EPIC) can be used in combination with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat patients with peritoneal carcinomatosis (PC) of multiple origins. The present study is a systematic review to evaluate the role of EPIC after CRS + HIPEC for appendiceal and colorectal cancers with PC.ContentWe conducted a systematic search in PubMed according to the PRISMA guidelines and included all studies published before June 27 of 2019 comparing EPIC to HIPEC or the combination of both. Our search found 79 articles. After excluding non-relevant articles, a total of 13 retrospective clinical studies reporting on the efficacy and safety of EPIC compared to HIPEC or as a combination therapy for lower gastrointestinal neoplasms were analyzed. Initial EPIC reports led to its declined usage because of concerns with increased postoperative morbidity and uncertain added benefit on survival. Recent retrospective studies have been promising, showing significant improvements in OS and fewer issues with complications when adding EPIC to CRS + HIPEC.ConclusionsCurrent evidence is entirely retrospective and is conflicting. It is hoped that ongoing clinical trials and additional studies will clarify EPIC’s role in the treatment of patients with PC. |
| Databáze: | OpenAIRE |
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