Kisser, A. and Kirisits, A. (2014): Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy of peritoneal carcinomatosis . Decision Support Document 74.
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Peritoneal carcinomatosis (PC) arising from local spread of abdominal tumours is poorly responsive to systemic chemotherapy. We reviewed current evidence on efficacy and safety of cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) compared to standard treatment of PC of colorectal, ovarian and gastric cancer origin.
Two randomised controlled trials and eight systematic reviews were evaluated. The level of evidence was moderate to low. The current evidence suggests that cytoreductive surgery combined with perioperative intraperitoneal chemotherapy is associated with an improved survival for PC from colorectal and gastric carcinoma with comparable morbidity to CRS alone. The two RCTs are however small and have several limitations. There is not sufficient evidence for PC of ovarian origin.
At present, we recommend against the inclusion of CRS+HIPEC in the Austrian BMG catalogue of procedures and suggest a re-evaluation in 2016.
|Item Type:||Decision Support Document|
|Keywords:||peritoneal carcinomatosis, hyperthermic chemotherapy, ovarian cancer, gastric cancer, colorectal cancer, cytoreductive surgery|
|Subjects:||WB Practice of medicine > WB 300-962 Therapeutics|
WI Digestive system > WI 900-970 Abdomen
W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
WI Digestive system > WI 300-387 Stomach
WP Gynaecology > WP 440-468 Uterine diseases
QZ Pathology > QZ 200-380 Neoplasms.Cysts
WI Digestive system > WI 400-560 Intestines
|Series Name:||Decision Support Document 74|
|Deposited on:||16 Jul 2014 12:41|
|Last Modified:||16 Jul 2014 12:41|
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