J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 1790KB） [Members Only]

J.Jpn. Surg. Soc.. 119(5): 509-514, 2018

Feature topic

CYTOREDUCTIVE SURGERY COMBINED WITH HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOR “MARGINALLY RESECTABLE” PERITONEAL METASTASIS

1) Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan
2) University Hospital Southampton, Southampton, UK

Hideaki Yano1)2), Yoshimasa Gohda1), Tomomichi Kiyomatsu1), Nobuyuki Takemura1), Kazuhiko 1), Norihiro Kokudo1)

Selected patients with colorectal liver or lung metastases can be cured by surgical resection. In contrast, peritoneal spread has been considered inevitably fatal and is called “peritoneal dissemination” or “peritoneal carcinomatosis.” Emerging evidence, however, suggests that certain patients can now be cured by a combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The body of evidence, accumulated through a large multiinstitutional registry, a randomized controlled study, and numerous case series, is substantial and has led to the incorporation of CRS+HIPEC for colorectal peritoneal metastasis into the national treatment guidelines in many developed countries. In the Japanese context, CRS+HIPEC has the potential of achieving a higher rate of curative resection, thereby improving survival in patients with P2 and P3 disease. Moreover, a higher rate of cure and improved survival are likely to be achieved in patients with P1 by adding HIPEC to the treatment regimen.

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