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Patient Selection for Treatment

  • Chapter
Treatment of Peritoneal Surface Malignancies

Part of the book series: Updates in Surgery ((UPDATESSURG))

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Abstract

Appropriate patient selection is of primary importance to successful cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC). Given the high morbidity rate associated with these combined procedures, we need to select patients who will derive maximum benefits from treatment and who carry lower risks of postoperative complications and mortality. The high morbidity and mortality rates, especially in treatment groups approaching this type of surgery for the first time, have raised concern and often criticism [1, 2]. At the same time, besides problems linked to postoperative complications, criteria for selecting patients to undergo integrated treatment must take into account preoperative factors predicting a favorable oncologic outcome. Hence, we need to know which tumors causing peritoneal spread this combined treatments should target and to define the extent of peritoneal spread to use as a cutoff beyond which these procedures are contraindicated. To rationalize this topic, even though schematizing has its limitations, we divided selection criteria according to whether they most directly address patients’ characteristics, the site and histology underlying peritoneal spread, and the extent of peritoneal and extraperitoneal malignant spread.

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Authors and Affiliations

  1. Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Rome, Italy

    Paolo Sammartino

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  1. Paolo Sammartino
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  2. Fabio Accarpio
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  3. Bianca Maria Sollazzo
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  4. Alessio Impagnatiello
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  5. Tommaso Cornali
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  6. Daniele Biacchi
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Correspondence to Paolo Sammartino .

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Editors and Affiliations

  1. Department of Surgery “Pietro Valdoni”, Sapienza University of Rome, Rome, Italy

    Angelo Di Giorgio

  2. Department of Medical, Surgical, and Neurological Sciences, University of Siena, Siena, Italy

    Enrico Pinto

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Sammartino, P., Accarpio, F., Sollazzo, B.M., Impagnatiello, A., Cornali, T., Biacchi, D. (2015). Patient Selection for Treatment. In: Di Giorgio, A., Pinto, E. (eds) Treatment of Peritoneal Surface Malignancies. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5711-1_13

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  • DOI: https://doi.org/10.1007/978-88-470-5711-1_13

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5710-4

  • Online ISBN: 978-88-470-5711-1

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