Review
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World J Gastroenterol. Nov 7, 2013; 19(41): 6979-6994
Published online Nov 7, 2013. doi: 10.3748/wjg.v19.i41.6979
Peritoneal carcinomatosis
Federico Coccolini, Federico Gheza, Marco Lotti, Salvatore Virzì, Domenico Iusco, Claudio Ghermandi, Rita Melotti, Gianluca Baiocchi, Stefano Maria Giulini, Luca Ansaloni, Fausto Catena
Federico Coccolini, Marco Lotti, Luca Ansaloni, Department of General Surgery, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy
Federico Gheza, Gianluca Baiocchi, Stefano Maria Giulini, Surgical Clinic, University of Brescia, 25123 Brescia, Italy
Salvatore Virzì, Domenico Iusco, Department of General Surgery, Bentivoglio Hospital, 40010 Bentivoglio, Italy
Claudio Ghermandi, Department of Anesthesiology, Sant’Orsola-Malpighi Hospital, 40100 Bologna, Italy
Rita Melotti, Regional Health Agency of Emilia Romagna, 40100 Bologna, Italy
Fausto Catena, Department of Emergency Surgery, Ospedale Maggiore, 43100 Parma, Italy
Author contributions: Coccolini F, Catena F and Ansaloni L designed research; Coccolini F, Gheza F, Ansaloni L, Baiocchi G, Ghermandi C, Melotti R, Giulini SM, Virzì S, Iusco D amd Lotti M analyzed data; Coccolini F, Gheza F, Virzì S and Iusco D wrote the paper; All authors read and approved the manuscript.
Correspondence to: Federico Coccolini, MD, Department of General Surgery, Papa Giovanni XXIII Hospital, P.zza OMS 1, 24127 Bergamo, Italy. federico.coccolini@gmail.com
Telephone: +39-35-2673486 Fax: +39-35-2674885
Received: July 10, 2013
Revised: September 12, 2013
Accepted: September 16, 2013
Published online: November 7, 2013
Processing time: 129 Days and 1 Hours
Abstract

Several gastrointestinal and gynecological malignancies have the potential to disseminate and grow in the peritoneal cavity. The occurrence of peritoneal carcinomatosis (PC) has been shown to significantly decrease overall survival in patients with liver and/or extraperitoneal metastases from gastrointestinal cancer. During the last three decades, the understanding of the biology and pathways of dissemination of tumors with intraperitoneal spread, and the understanding of the protective function of the peritoneal barrier against tumoral seeding, has prompted the concept that PC is a loco-regional disease: in absence of other systemic metastases, multimodal approaches combining aggressive cytoreductive surgery, intraperitoneal hyperthermic chemotherapy and systemic chemotherapy have been proposed and are actually considered promising methods to improve loco-regional control of the disease, and ultimately to increase survival. The aim of this review article is to present the evidence on treatment of PC in different tumors, in order to provide patients with a proper surgical and multidisciplinary treatment focused on optimal control of their locoregional disease.

Keywords: Carcinosis; Peritoneal; Ovarian; Gastric; Colorectal; Hipec; Intraperitoneal chemotherapy; Cytoreductive surgery; Cancer; Advanced

Core tip: This review aims to present the evidence on treatment of peritoneal carcinosis in different tumors, in order to provide patients with a proper surgical and multidisciplinary treatment focused on optimal control of their locoregional disease.