The combined technique of cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion

The multimodal approach using macroscopic cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion (HITHOC) may improve local tumor control and prognosis of patients with primary and secondary pleural tumors. After complete surgical cytoreduction, consisting of parietal and visceral pleurectomy, the intraoperative HITHOC procedure allows for better local dissemination and a higher concentration of the chemotherapeutics in the pleural cavity in contrast to systemic application. This new combined treatment strategy can result in improved patient survival with acceptable morbidity and mortality in selected patients, having no indication for radical resection (extrapleural pneumonectomy). Patients with primary and secondary tumors of the pleural should be evaluated by an interdisciplinary team, concerning this therapeutic alternative. In this report, cytoreductive surgery combined with hyperthermic intrathoracic chemotherapy perfusion is discussed, and the current literature is reviewed.