Sugarbaker Paul H
Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC 20010 USA.
Indian J Surg Oncol. 2019 Mar;10(1):3-23. doi: 10.1007/s13193-018-0856-1. Epub 2019 Jan 3.
Peritoneal metastases may occur from a majority of cancers that occur within the abdomen or pelvis. When cancer spread to the peritoneal surfaces is documented, a decision regarding palliation versus an aggressive approach using cytoreductive surgery (CRS) and hyperthermic perioperative intraperitoneal chemotherapy (HIPEC) must be made. This decision is dependent on a well-defined group of prognostic indicators. In addition to treatment, prevention of peritoneal metastases may be an option. The clinical and pathologic features of a primary cancer can be used to select perioperative treatments that may prevent cancer cells within the abdomen and pelvis from progressing to established peritoneal metastases. In some clinical situations with appendiceal and colorectal cancers, the clinical or histopathologic features may indicate that second-look surgery plus perioperative chemotherapy should occur. Peritoneal metastases should always be considered by the multidisciplinary team for treatment or prevention.
大多数发生于腹部或盆腔的癌症都可能出现腹膜转移。当有记录表明癌症已扩散至腹膜表面时，必须做出关于姑息治疗还是采用减瘤手术（CRS）和术中腹腔内热灌注化疗（HIPEC）的积极治疗方法的决定。这一决定取决于一组明确的预后指标。除了治疗之外，预防腹膜转移也可能是一种选择。原发性癌症的临床和病理特征可用于选择围手术期治疗方法，这些方法可能会阻止腹盆腔内的癌细胞发展为已确诊的腹膜转移。在某些阑尾癌和结直肠癌的临床情况下，临床或组织病理学特征可能表明应进行二次探查手术并联合围手术期化疗。多学科团队在考虑治疗或预防措施时应始终考虑腹膜转移。
