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Invited Critique
Oct 2012

The Heat of the MatterComment on “Initial Experience With Hyperthermic Intraperitoneal Chemotherapy”

Author Affiliations

Author Affiliation: Department of Surgery, The Johns Hopkins University, Baltimore, Maryland.

Arch Surg. 2012;147(10):924. doi:10.1001/archsurg.2012.1292

Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is being increasingly offered for treatment of peritoneal carcinomatosis. Recent data on colorectal cancer from several large retrospective multicenter trials1,2 and a prospective randomized trial3 have shown promising overall survival, with 5-year survival approaching 40% in patients with complete cytoreduction. Cytoreductive surgery and HIPEC are delivered as a package deal with the concept of complete cytoreductive surgery to remove all macroscopic peritoneal disease followed by HIPEC to treat the microscopic disease burden. However, there remains persistent concern among the oncologic community about the morbidity and mortality of the procedure. The article by Turrini et al4 is a well-timed study showing that cytoreductive surgery and HIPEC can be performed with low mortality and acceptable morbidity by an experienced, high-volume team.

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