TREATMENT OF PERITONEAL CARCINOMATOSIS BY INTRAPERITONEAL CHEMOHYPERTHERMIA - RELIABLE AND UNRELIABLE CONCEPTS

Intraoperative Peritoneal chemo-hyperthermia (IPCH) is a promising tre atment of peritoneal carcinomatosis arising from digestive tumors. Aft er presenting the rationale for the use of IPCH, this review reports t he results published to date by different groups. Unfortunately, data with respect to technical aspects, indications and results are unclear , inhomogeneous and questionable. The discussion presents reliable and unreliable points, mainly concerning the technical aspects of IPCH: w hat is the maximal desirable tumor thickness before initiating treatme nt? What is the ideal temperature? Is central hyperthermia beneficial? What is the ideal duration? What is the most effective antimitotic dr ug? A new classification of peritoneal seeding before cytoreductive su rgery and before the initiation of IPCH, is proposed, and a suggestion concerning the reporting of drug concentrations made. Numerous prospe ctive studies need to be conducted to test different technical modalit ies and to evaluate the results of IPCH.