Management of Peritoneal Surface Malignancies. (Cytoreductive Surgery, HIPEC, PIPAC, and Beyond)

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About this Research Topic

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Background

Peritoneal surface malignancies (PSM) include a heterogeneous group of primary tumors, like peritoneal mesothelioma, and peritoneal metastases from various origins such as ovarian, gastric, colorectal, or appendicular cancers. Their pathophysiology is complex and still not fully elucidated. Historically, due to their dismal prognosis, peritoneal surface malignancies were considered a terminal condition and treated as such in palliative intent.. Surgery has become pivotal in the treatment of PSM and the development of specific techniques of cytoreductive surgery (peritonectomies, “en-bloc” resection) open up a new era of curative intent treatments.
With that, many questions are of interest to care-providers, for instance, the extent of patient and tumor characteristics’ role in tailoring the surgery, how the therapeutic agenda can encompass patient wishes and provide satisfactory patient reported outcomes, the way to developing multimodal strategies including HIPEC and other adjuvant treatments

Nowadays, surgery in palliative settings and the new modalities of drug distribution like pressurized intraperitoneal aerosol chemotherapy (PIPAC) are also becoming more and more discussed. In fact, PIPAC is currently assessed in PSM of various origins with a special focus on the quality of life involvement, where this therapy would be used as a new modality of locoregional intensification making the further completion of CRS possible.

Numerous ongoing clinical trials are also analyzing optimal strategic combinations, especially as targeted therapies have opened new therapeutic perspectives and opportunities. However, as there is still need for preclinical proof supporting these new therapeutic modalities, surgical treatment remains the mainstay of management for these diseases.

The aim of this special issue is to give the reader an overview of the state of the art in the management of PSMs with a special focus on surgical treatments and techniques. We will consider surgery as part of the therapeutic sequences, with an insight into the possibility of optimizing the therapeutic agenda for frail patients and elderly. Exploring the surgical procedure from the prehabilitation phase to a fast recovery protocol, we will also integrate patients' reported outcomes and quality of life in the picture.


Important Note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.

Keywords: peritoneal surface malignancies, Cytoreductive surgery, HIPEC, PIPAC, Ovarian cancer

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