Peritoneal Surface Oncology: A progress report.

The Fourth International Workshop on Peritoneal Surface Malignancy took place in Madrid (Spain) on December 2, 3 and 4, 2004. The meeting brought together 132 health care professionals currently working on or interested in the management of peritoneal surface malignancy, from 19 countries. The topics covered included diagnostic pathology, technology of hyperthermic peritoneal perfusion, quantitative prognostic indicators, accreditation of treatment programs, ovarian cancer, gastric cancer, peritoneal mesothelioma, appendiceal mucinous tumors, colorectal cancer, morbidity and mortality, and were presented by 25 invited speakers. This article summarizes the most significant discussion points and conclusions relative to the aforementioned topics. The following consensus points were reached: (1) cytoreductive surgery combined with perioperative intraperitoneal chemotherapy is unquestionably considered the standard of care for mucinous appendiceal tumors with peritoneal spread at the present time; (2) there is a need for standardization in the nomenclature used in this field and as a first step "HIPEC" was chosen as the recommended acronym to be used to refer to hyperthermic intraperitoneal chemotherapy in the future; (3) close international collaboration is needed to advance in the standardization of prognostic indicators, technology for HIPEC, accreditation of peritoneal surface malignancy treatment programs, anesthesia management and pathology, and ad hoc working groups were assembled for some of these issues. Future directions for clinical research in this field, especially in carcinomatosis of colorectal origin were identified and extensively discussed.