Hyperthermic intraperitoneal chemotherapy: time-tested but still outside Russian clinical guidelines

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Abstract

Peritoneal carcinomatosis is one of the most unfavorable scenarios in the progression of malignant tumors and substantially worsens the prognosis in ovarian cancer, colorectal cancer, gastric cancer, pancreatic cancer, appendiceal tumors, and other oncological diseases. We reviewed current data on the use of hyperthermic intraperitoneal chemotherapy (HIPEC) in combination with cytoreductive surgery for secondary peritoneal carcinomatosis associated with various malignant tumors.

The results of several randomized trials and large observational studies suggest that HIPEC may improve survival, reduce the risk of recurrence, and enhance local disease control in selected groups of patients. The most convincing evidence has been obtained for ovarian, gastric, colorectal, pancreatic, and appendiceal malignancies. At the same time, the evidence base remains heterogeneous: the efficacy of HIPEC depends on the tumor type, disease extent, completeness of cytoreduction, chemotherapy regimen, and patient selection. Despite the accumulated clinical experience and a substantial body of evidence, representation of this technique in Russian clinical guidelines is still very limited. Further randomized studies could help generate more data on the efficacy of HIPEC and the specifics of its clinical application, accelerate its incorporation into Russian clinical protocols, thereby make it more accessible to patients with advanced-stage oncological diseases.

About the authors

A. A. Ivanov

MAMMA Medical Clinic

Author for correspondence.
Email: dr_anton_ivanov@mail.ru
ORCID iD: 0000-0001-6091-0848
Russian Federation, 7B Vokzalnaya St., Odintsovo, 143007

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