Citation: Sommariva, A.; Valle, M.;
Gelmini, R.; Tonello, M.; Carboni, F.;
De Manzoni, G.; Sorrentino, L.;
Pasqual, E.M.; Bacchetti, S.; Sassaroli,
C.; et al. Laparoscopic Cytoreduction
Combined with Hyperthermic
Intraperitoneal Chemotherapy
(HIPEC) in Peritoneal Surface
Malignancies (PSM): Italian PSM
Oncoteam Evidence and Literature
Review. Cancers 2023, 15, 279.
https://doi.org/10.3390/
cancers15010279
Academic Editor: Jan Willem B. de
Groot
Received: 9 November 2022
Revised: 29 December 2022
Accepted: 29 December 2022
Published: 31 December 2022
Copyright: © 2022 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
cancers
Systematic Review
Laparoscopic Cytoreduction Combined with Hyperthermic
Intraperitoneal Chemotherapy (HIPEC) in Peritoneal Surface
Malignancies (PSM): Italian PSM Oncoteam Evidence and
Literature Review
Antonio Sommariva
1,
* , Mario Valle
2
, Roberta Gelmini
3
, Marco Tonello
1
, Fabio Carboni
2
,
Giovanni De Manzoni
4
, Lorena Sorrentino
3
, Enrico Maria Pasqual
5
, Stefano Bacchetti
5
, Cinzia Sassaroli
6
,
Andrea Di Giorgio
7
, Massimo Framarini
8
, Daniele Marrelli
9
, Francesco Casella
4
and Orietta Federici
2
1
Advanced Surgical Oncology Unit, Unit of Surgical Oncology of the Esophagus and Digestive Tract,
Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy
2
Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
3
SC Chirurgia Generale d’Urgenza ed Oncologica, AOU Policlinico di Modena, 41125 Modena, Italy
4
Upper GI Surgery Division, University of Verona, 37134 Verona, Italy
5
AOUD Center Advanced Surgical Oncology, DAME University of Udine, 33100 Udine, Italy
6
Colorectal Surgical Oncology, Abdominal Oncology Department, “Fondazione Giovanni Pascale” IRCCS,
80131 Naples, Italy
7
Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario A. Gemelli—IRCCS,
00168 Rome, Italy
8
Surgery and Advanced Oncological Therapy Unit, Ospedale “GB.Morgagni-L.Pierantoni”—AUSL Forlì,
47121 Forlì, Italy
9
Department of Medicine, Surgery, and Neurosciences, Unit of General Surgery and Surgical Oncology,
University of Siena, 53100 Siena, Italy
* Correspondence: antonio.sommariva@iov.veneto.it; Tel.: +39-423-421306
Simple Summary: Mini-invasive surgery represents an interesting yet challenging technical evolu-
tion for treating peritoneal metastases. This retrospective study aims to present the experience of the
Italian Peritoneal Surface Malignancies Oncoteam with laparoscopic cytoreductive surgery (CRS)
and hyperthermic intraperitoneal chemotherapy (HIPEC), including a detailed description of the
technique and a systematic review of the literature. The study shows the feasibility and safety of
laparoscopic CRS-HIPEC and its association with favorable outcomes in properly selected patients.
Abstract: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC)
has gained increasing acceptance in clinical practice. Performing CRS and HIPEC laparoscopically
represents a challenging and intriguing technical evolution. However, the experiences are limited, and
the evidence is low. This retrospective analysis was performed on patients treated with laparoscopic
CRS-HIPEC within the Italian Peritoneal Surface Malignancies Oncoteam. Clinical, perioperative,
and follow-up data were extracted and collected on prospectively maintained databases. We added
a systematic review according to the PRISMA method for English-language articles through April
2022 using the keywords laparoscopic, hyperthermic, HIPEC, and chemotherapy. From 2016 to
2022, fourteen patients were treated with Lap-CRS-HIPEC with curative intent within the Italian
centers. No conversion to open was observed. The median duration of surgery was 487.5 min. The
median Peritoneal Cancer Index (PCI) was 3, and complete cytoreduction was achieved in all patients.
Two patients (14.3%) had major postoperative complications, one requiring reintervention. After a
median follow-up of 16.9 months, eleven patients were alive without disease (78.6%), two patients
developed recurrence (14.3%), and one patient died for unrelated causes (7.1%). The literature review
confirmed these results. In conclusion, current evidence shows that Lap-CRS-HIPEC is feasible, safe,
and associated with a favorable outcome in selected patients. An accurate patient selection will
continue to be paramount in choosing this treatment.
Keywords: peritoneal metastases; cytoreductive surgery; HIPEC; laparoscopy
Cancers 2023, 15, 279. https://doi.org/10.3390/cancers15010279 https://www.mdpi.com/journal/cancers