Polish clinical practice guideline on hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery in peritoneal malignancy treatment
Piotr Rutkowski1, Beata Śpiewankiewicz2, Krzysztof Herman3, Tomasz Jastrzębski4, Józef Kładny5, Zbigniew Kojs3, Maciej Krzakowski6, Wojciech Polkowski7, Lucjan Wyrwicz8, Piotr Wysocki9, Marcin Zdzienicki1, Wojciech Zegarski10
Affiliacja i adres do korespondencjiThe management of peritoneal surface malignancy is a significant clinical problem in oncology. It was demonstrated that the combination of complete cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) may lead to long-term control of the disease or improved survival in selected patients. The aim of this paper was to present the optimal indications and technical guidelines for performing HIPEC in Poland. The application of this method requires experience of a multidisciplinary team of physicians (gynecologic oncologist, surgeon and clinical oncologist), availability of diagnostic and therapeutic resources (intensive care unit) as well as a dedicated perfusion system. A crucial aspect for obtaining optimal treatment outcomes is the selection of patients. Such a selection takes place both at the beginning of treatment and intraoperatively. The initial selection of patients qualified for HIPEC includes ruling out extraperitoneal spread of cancer and metastases to the liver (single resectable liver metastases in patients with colorectal carcinoma are not contraindications) and lungs. According to current international guidelines, the HIPEC procedure is a standard treatment in patients with ovarian carcinoma that metastasizes to the peritoneum, in colorectal cancer, when PCI <20 and in patients with peritoneal mesothelioma or pseudomyxoma peritonei as well as in patients with gastric cancer.
