Peritoneal carcinomatosis of gastrointestinal tumors: Where are we now?

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摘要 Theperitonealstromaltissuewhichprovidesarichsourceofgrowthfactorsandchemokinesisafavorableenvironmentfortumorproliferation.Thepathophysiologicalmechanismofperitonealcarcinomatosisisanindividualsequenceconsistingofgeneticandenvironmentalfactorsandremainscontroversial.Thenaturalhistoryofthediseaserevealsapoormedianprognosisofapproximately6mo;howeveraggressivesurgeryandmultimodaltreatmentoptionscanimproveoncologicoutcomes.Consideringperitonealcarcinomatosisasthoughitisalocoregionaldiseasebutnotametastaticprocess,cytoreductivesurgeryandandintraperitonealchemotherapyhasbeenacurativeoptionduringrecentyears.Cytoreductivesurgeryimpliesaseriesofvisceralresectionsandperitonectomyprocedures.Althoughtheaimofcytoreductivesurgeryistoeliminateallmacroscopicdisease,viabletumorcellsmayremainintheperitonealcavity.Atthatpoint,intraperitonealchemotherapycanextendthemacroscopicdiseaseeliminationtomicroscopicdiseaseelimination.Thesuccessfultreatmentofperitonealcarcinomatosisrequiresacomprehensivemanagementplanincludingproperpatientselection,completeresectionofallvisibledisease,perioperativeintraperitonealchemotherapyandpostoperativesystemicchemotherapy.Surgicalandoncologicoutcomesarestrictlyassociatedwithextentofthetumor,completenessofcytoreductionandpatientrelatedfactorsaswellasmultidisciplinarymanagementandexperienceofthesurgicalteam.Inthisreview,pathophysiologyandcurrentmanagementofperitonealcarcinomatosisoriginatingfromgastrointestinaltumorsarediscussedaccordingtothelatestliterature.
机构地区 不详
出版日期 2014年12月22日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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