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Innere Medizin 1. März 2009

Potentially curative strategies in peritoneal metastases

PURPOSE: Synopsis about the curative possibilities of an aggressive multimodal therapeutic approach for peritoneal metastases using positive prognostic selection criteria. PATIENTS AND METHODS: Published data concerning cytoreductive surgery in combination with intraoperative intraperitoneal hyperthermic chemotherapy and/or early postoperative intraperitoneal chemotherapy ± systemic chemotherapy in patients suffering from peritoneal carcinomatosis were analyzed with regard to subgroups with long-term survivors. RESULTS: Extent of peritoneal carcinomatosis and completeness of cytoreductive surgery are the most important prognostic factors predicting long-term survival. Histological differentiation, lymph node status, performance status, extent of prior therapy and age are further independent factors influencing the outcome. CONCLUSION: Strictly selecting patients with multiple positive prognostic factors might result in 5-year survival rates of 50% and more.

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