Delarbete IV – Kemosensitivitet och val av cytostatika
7.3 Slutsatser
Denna avhandling har undersökt tre aspekter av cytoreduktiv kirurgi och intraperitoneal cytostatika behandling av bukhinnespridd tjock- och änd-tarmscancer. Vad gäller överlevnadsanalysen verkar denna behandling kun-na vara botande i 15-32% av fallen beroende på vilken grupp man tittar på.
Det viktigaste är att få ner antalet patienter som stängs utan åtgärd. Vad gäll-er patientselektionen så har ett prognostiskt poängsystem utvecklats. Den kan bli ett viktigt verktyg i patientselektionsprocessen och kan komplettera radiologin. Vad gäller den intraperitoneala cytostatika-aspekten så är HI-PEC-metoden att föredra framför SPIC-metoden och teoretiskt kan oxalipla-tin vara att föredra framför mitomycin C men detta behöver bekräftas genom en klinisk studie.
8 Acknowledgements
Determination and inspiration are two crucial elements needed to succeed in research. I am very glad to say that I have had many supporters during my thesis research. This has given me the motivation needed to stay determined and inspired.
The closest supporters I have had are my family. I would like to especially thank my wonderful wife, Helena, for her love and support in every way, for her patience with my faults, and for sharing great moments together as well as struggles that have strengthened us. I am also thankful for my son, Joseph, for providing joy in my life and the child on its way, for reminding me of new beginnings. I cannot express my gratefulness for their encouragement and companionship in life. I would also like to thank my parents, David and Margareta Cashin, for developing in me an inquisitive mind and supporting me in my studies. They have always been there and given their blessing to me in regards to decisions of academia and life.
A good research environment entails supportive friends and colleagues. This has been instrumental for me in developing an interest in research. I am par-ticularly blessed with an exceptional tutor, Associate Professor Haile Ma-hteme, who is an amazing motivator. He has been genuinely interested in seeing me succeed and he is a great friend and teacher. His friendship is characterised by much generosity which I hope to cultivate in my own life. I look forward to further discussions on both research and other topics in the operating room or in a summer cottage.
I would like to thank my co-tutors, Professor Wille Graf and Professor Peter Nygren, for their support and encouragement in research and writing. Par-ticularly, I would like to thank Wille for his support and teaching in the op-erating room and Peter for his astute and insightful examination of my re-search material and his help in keeping the rere-search concise and focused.
I would also like to thank the following colleagues and collaborators for their help and support of this thesis and my clinical development:
Claes Juhlin, head of the department of surgery at Uppsala University Hospi-tal (Akademiska Sjukhuset), Professor Lars Wiklund, former chair of the department of surgical sciences at Uppsala University and the current chair,
Professor Olle Nilsson, for providing support and facilities for scientific and clinical work.
Olle Norlén and Håkan Andréasson for their friendship and enthusiastic dis-cussions on research topics and potential new research ideas.
The operating team, Vivvi, Anna, Kristin, for their support during surgical training and for their encouragement.
Rolf Larsson and Henning Karlsson for their co-authorship in the last article of this thesis.
Lastly, I would like to thank Akademiska Sjukhuset and Uppsala University for providing a research environment, funding, and facilities to use during my research and clinical training.
9 References
1. GLOBOCAN 2008 - Cancer Incidence, Mortality and Prevalance World-wide in 2008. International Agency for Research on Cancer at <www-dep.iarc.fr>
2. Jayne DG, Fook S, Loi C & Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg 89, 1545–1550 (2002).
3. Lemmens VE, et al. Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: A population-based study. Int J Cancer 128, 2717–2725 (2011).
4. Segelman J, et al. Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer. Br J Surg doi:10.1002/bjs.8679 (2012).
5. Cancer i siffror 2009 @
http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/8348/2009-126-127_2009126127.pdf
6. Klaver YLB, et al. Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of pallia-tive chemotherapy. Ann Oncol 22, 2250 –2256 (2011).
7. Shepherd NA, Baxter KJ & Love SB. The prognostic importance of perito-neal involvement in colonic cancer: a prospective evaluation. Gastroen-terology 112, 1096–1102 (1997).
8. Leather AJ, et al. Detection of free malignant cells in the peritoneal cavity before and after resection of colorectal cancer. Dis Colon Rectum 37, 814–
819 (1994).
9. Oosterling SJ, van der Bij GJ, van Egmond M & van der Sijp JRM. Surgi-cal trauma and peritoneal recurrence of colorectal carcinoma. Eur J Surg Oncol 31, 29–37 (2005).
10. Longo DL & Young RC. The natural history and treatment of ovarian can-cer. Annu Rev Med 32, 475–490 (1981).
11. Silberman, A. W. Surgical debulking of tumors. Surg Gynecol Obstet 155, 577–585 (1982).
12. Toro DH, Reyes LI & Velázquez J. Pseudomyxoma peritonei: case report and review of the literature. Bol Asoc Med P R 82, 355–358 (1990).
13. Pyper RA. Peritoneal Dialysis. Ulster Med J 17, 179–187 (1948).
14. Dedrick RL, Myers CE, Bungay PM & DeVita VT. Pharmacokinetic ra-tionale for peritoneal drug administration in the treatment of ovarian can-cer. Cancer Treat Rep 62, 1–11 (1978).
15. Hart GD. Palliative management of gastrointestinal cancer. Can Med Assoc J 90, 1265–1268 (1964).
16. Moertel CG & Reitemeier RJ. Proc Mayo Clin. 37, 520 (1962).
17. Ryan RF, et al. Selected perfusion of isolated viscera with chemotherapeu-tic agents using an extracorporeal circuit. Surg Forum 8, 158–161 (1957).
18. Shingleton WW, Parker RT & Mahaley S. Abdominal Perfusion for Cancer Chemotherapy. Ann Surg 152, 583–591 (1960).
19. Woodhall B, Reynolds DH, Mahaley S & Sanders AP. The physiologic and pathologic effects of localized cerebral hypothermia. Ann Surg 147, 673–
683 (1958).
20. Schmahl D & Druckrey H. Beitrage zum Wirkungsmechanismus von N-oxyd-lost. Naturwissenschaften 199 (1956).
21. Shingleton WW, Reeves JW, Keppel RA, Mahaley S & Taylor IM. Studies on abdominal organ perfusion for cancer chemotherapy. Ann Surg 151, 741–749 (1960).
22. Woodhall B, Pickrell KL, Georgiade NG, Mahaley MS. & Dukes HT. Ef-fect of Hyperthermia Upon Cancer Chemotherapy: Application to External Cancers of Head and Neck. Ann Surg 151, 750–758 (1960).
23. Spratt JS, Adcock RA, Sherrill W & Travathen S. Hyperthermic peritoneal perfusion system in canines. Cancer Res 40, 253–255 (1980).
24. Dedrick RL. Theoretical and experimental bases of intraperitoneal chemo-therapy. Semin Oncol 12, 1–6 (1985).
25. Markman M. Cytotoxic intracavitary chemotherapy. Am J Med Sci 291, 175–179 (1986).
26. Sugarbaker PH. Peritonectomy procedures. Ann Surg 221, 29–42 (1995).
27. Carry PY, et al. [Peroperative intraperitoneal chemohyperthermia (CHIP) in peritoneal cancer: feasibility of the method; preliminary study of 2 cases]. Ann Fr Anesth Reanim 8 Suppl, R44 (1989).
28. Fujimoto S, et al. Combined treatment with surgery and intraperitoneal hyperthermic perfusion (IPHP) for far-advanced gastrointestinal cancer with peritoneal seeding. Acta Med Austriaca 16, 76–80 (1989).
29. Gilly FN, et al. [Treatment of peritoneal carcinomatosis by intraperitoneal chemo-hyperthermia with mitomycin C. Initial experience]. Ann Chir 44, 545–551 (1990).
30. Fujimoto S, et al. Intraperitoneal hyperthermic perfusion combined with surgery effective for gastric cancer patients with peritoneal seeding. Ann Surg 208, 36–41 (1988).
31. Sugarbaker PH, et al. Pseudomyxoma peritonei syndrome. Adv Surg 30, 233–280 (1996).
32. Salle B, et al. [Intraperitoneal chemo-hyperthermia in the treatment of peritoneal carcinomatosis of ovarian origin. Initial cases, physiopathologic data]. J Gynecol Obstet Biol Reprod 22, 369–371 (1993).
33. Schneebaum S, et al. Intraperitoneal hyperthermic perfusion with mitomy-cin C for colorectal cancer with peritoneal metastases. Ann Surg Oncol 3, 44–50 (1996).
34. Mongero LB, Beck JR, Kroslowitz RM, Argenziano M & Chabot JA.
Treatment of primary peritoneal mesothelioma by hyperthemic intraperito-neal chemotherapy. Perfusion 14, 141–145 (1999).
35. Moran B, Baratti D, Yan TD, Kusamura S & Deraco M. Consensus state-ment on the loco-regional treatstate-ment of appendiceal mucinous neoplasms with peritoneal dissemination (pseudomyxoma peritonei). J Surg Oncol 98, 277–282 (2008).
36. Deraco M, Bartlett D, Kusamura S & Baratti D. Consensus statement on peritoneal mesothelioma. J Surg Oncol 98, 268–272 (2008).
37. Harrison S & Benziger H. The molecular biology of colorectal carcinoma and its implications: a review. Surgeon 9, 200–210 (2011).
38. Fearon ER & Vogelstein B. A genetic model for colorectal tumorigenesis.
Cell 61, 759–767 (1990).
39. David AR & Zimmerman MR. Cancer: an old disease, a new disease or something in between? Nat Rev Cancer 10, 728–733 (2010).
40. Eccles WM. Carcinoma of the Ascending Colon and its Treatment, with the Record of Two Cases. Br Med J 1, 69–71 (1900).
41. Miles W. A method for performing abdomino-perineal excision for carci-noma of the rectum and the terminal portion of the pelvic colon. Lancet 1812–1813 (1908).
42. Cunningham D, et al. Colorectal cancer. Lancet 375, 1030–1047 (2010).
43. Lloyd-Davies OV. Carcinoma of the rectum with a single secondary in the liver; synchronous combined excision and left hepatectomy. Proc R Soc Med 40, 875 (1947).
44. Peden JC & Blalock WN. Right hepatic lobectomy for metastatic carci-noma of the large bowel. Cancer 16, 1133–1140 (1963).
45. Wilson SM. & Adson MA. Surgical treatment of hepatic metastases from colorectal cancers. Arch Surg 111, 330–334 (1976).
46. Adam R & Vinet E. Regional treatment of metastasis: surgery of colorectal liver metastases. Ann Oncol 15 Suppl 4, iv103–106 (2004).
47. Mahmoud N & Bullard Dunn K. Metastasectomy for stage IV colorectal cancer. Dis Colon Rectum 53, 1080–1092 (2010).
48. Franko J, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion versus systemic chemotherapy alone for colorectal perito-neal carcinomatosis. Cancer 116, 3756–3762 (2010).
49. Elias D, et al. Complete cytoreductive surgery plus intraperitoneal chemo-hyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin. J Clin Oncol 27, 681–685 (2009).
50. Sanoff HK, et al. Five-year data and prognostic factor analysis of ox-aliplatin and irinotecan combinations for advanced colorectal cancer:
N9741. J Clin Oncol 26, 5721–5727 (2008).
51. Verwaal VJ, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 21, 3737–3743 (2003).
52. Esquivel J, Elias D, Baratti D, Kusamura S & Deraco M. Consensus state-ment on the loco regional treatstate-ment of colorectal cancer with peritoneal dis-semination. J Surg Oncol 98, 263–267 (2008).
53. Jacquet P & Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. Cancer Treat Res 82, 359–374 (1996).
54. Svirbely JE, Pesce AJ, Singh S & O’Flaherty EJ. Co-trimoxazole (sul-phamethoxazole plus trimethoprim) peritoneal barrier transfer pharmacoki-netics. Clin Pharmacokinet 16, 317–325 (1989).
55. Hirszel P, Shea-Donohue T, Chakrabarti E, Montcalm E & Maher JF. The role of the capillary wall in restricting diffusion of macromolecules. A study of peritoneal clearance of dextrans. Nephron 49, 58–61 (1988).
56. Czyzewska K. Transperitoneal transport dynamics of methotrexate in vitro:
tissue and diffusion barriers. J Physiol Pharmacol 46, 185–194 (1995).
57. Yonemura Y, et al. Multidisciplinary therapy for treatment of patients with peritoneal carcinomatosis from gastric cancer. World J Gastrointest Oncol 2, 85–97 (2010).
58. Los G, Mutsaers PH, Lenglet WJ, Baldew GS & McVie JG. Platinum dis-tribution in intraperitoneal tumors after intraperitoneal cisplatin treatment.
Cancer Chemother Pharmacol 25, 389–394 (1990).
59. Elias D, et al. Heated intra-operative intraperitoneal oxaliplatin after com-plete resection of peritoneal carcinomatosis: pharmacokinetics and tissue distribution. Ann Oncol 13, 267–272 (2002).
60. Barlogie B, Corry PM & Drewinko B. In vitro thermochemotherapy of human colon cancer cells with cis-dichlorodiammineplatinum(II) and mi-tomycin C. Cancer Res 40, 1165–1168 (1980).
61. Pelz JO, Doerfer J, Dimmler A, Hohenberger W & Meyer T. Histological response of peritoneal carcinomatosis after hyperthermic intraperitoneal chemoperfusion (HIPEC) in experimental investigations. BMC Cancer 6, 162 (2006).
62. Leunig M, et al. Interstitial fluid pressure in solid tumors following hyper-thermia: possible correlation with therapeutic response. Cancer Res 52, 487–490 (1992).
63. Giovanella BC, Stehlin JS & Morgan AC. Selective Lethal Effect of Supra-normal Temperatures on Human Neoplastic Cells. Cancer Res 36, 3944 – 3950 (1976).
64. Elias D, et al. Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy.
Cancer 92, 71–76 (2001).
65. Glehen O, et al. Cytoreductive surgery combined with perioperative intrap-eritoneal chemotherapy for the management of pintrap-eritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol 22, 3284–
3292 (2004).
66. Mahteme H, et al. Improved survival in patients with peritoneal metastases from colorectal cancer: a preliminary study. Br J Cancer 90, 403–407 (2004).
67. Yan TD & Morris DL. Cytoreductive surgery and perioperative intraperito-neal chemotherapy for isolated colorectal peritointraperito-neal carcinomatosis: ex-perimental therapy or standard of care? Ann Surg 248, 829–835 (2008).
68. Glehen O, et al. Hyperthermic intraperitoneal chemotherapy: nomenclature and modalities of perfusion. J Surg Oncol 98, 242–246 (2008).
69. Kusamura S, Dominique E, Baratti D, Younan R & Deraco M. Drugs, carrier solutions and temperature in hyperthermic intraperitoneal chemo-therapy. J Surg Oncol 98, 247–252 (2008).
70. Zakris EL, et al. Pharmacokinetics and toxicity of intraperitoneal cisplatin combined with regional hyperthermia. J Clin Oncol 5, 1613–1620 (1987).
71. Gilly FN, et al. Tolerance of intraperitoneal chemohyperthermia with mi-tomycin C: in vivo study in dogs. Int J Hyperthermia 8, 659–666 (1992).
72. Elias D, et al. Optimization of hyperthermic intraperitoneal chemotherapy with oxaliplatin plus irinotecan at 43 degrees C after compete cytoreductive surgery: mortality and morbidity in 106 consecutive patients. Ann Surg On-col 14, 1818–1824 (2007).
73. Armstrong DK, et al. Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med 354, 34–43 (2006).
74. Blumenthal RD. An overview of chemosensitivity testing. Methods Mol Med 110, 3–18 (2005).
75. Lindhagen E, Nygren P & Larsson R. The fluorometric microculture cyto-toxicity assay. Nat Protoc 3, 1364–1369 (2008).
76. Sugarbaker PH, et al. Prospective, randomized trial of intravenous versus intraperitoneal 5-fluorouracil in patients with advanced primary colon or rectal cancer. Surgery 98, 414–422 (1985).
77. Cavaliere F, et al. Prognostic factors and oncologic outcome in 146 patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: Italian multi-center study S.I.T.I.L.O. Eur J Surg Oncol 37, 148–154 (2011).
78. Elias D, et al. Peritoneal Colorectal Carcinomatosis Treated With Surgery and Perioperative Intraperitoneal Chemotherapy: Retrospective Analysis of 523 Patients From a Multicentric French Study. J Clin Oncol 28, 63 –68 (2010).
79. Verwaal VJ, et al. Long-term survival of peritoneal carcinomatosis of colo-rectal origin. Ann Surg Oncol 12, 65–71 (2005).
80. Shen P, et al. Peritoneal surface disease from colorectal cancer: comparison with the hepatic metastases surgical paradigm in optimally resected pa-tients. Ann Surg Oncol 15, 3422–3432 (2008).
81. Sommariva A, Pilati P & Rossi CR. Cyto-reductive Surgery combined with Hyperthermic Intra-Peritoneal Chemotherapy for Peritoneal Surface Malig-nancies: Current treatment and results. Cancer Treat Rev doi:10.1016/j.ctrv.2011.07.001 (2011)
82. Elias D, et al. Treatment of peritoneal carcinomatosis from colorectal can-cer: impact of complete cytoreductive surgery and difficulties in conducting randomized trials. Ann Surg Oncol 11, 518–521 (2004).
83. Portilla AG, Sugarbaker PH & Chang D. Second-look surgery after cytore-duction and intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer: analysis of prognostic features. World J Surg 23, 23–29 (1999).
84. Verwaal VJ, Boot H, Aleman BMP, van Tinteren H & Zoetmulder FAN.
Recurrences after peritoneal carcinomatosis of colorectal origin treated by cytoreduction and hyperthermic intraperitoneal chemotherapy: location, treatment, and outcome. Ann Surg Oncol 11, 375–379 (2004).
85. Bijelic L, Yan TD & Sugarbaker PH. Treatment failure following complete cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal dissemination from colorectal or appendiceal mucinous neo-plasms. J Surg Oncol 98, 295–299 (2008).
86. Brouquet A, et al. The second procedure combining complete cytoreductive surgery and intraperitoneal chemotherapy for isolated peritoneal recur-rence: postoperative course and long-term outcome. Ann Surg Oncol 16, 2744–2751 (2009).
87. Cotte E, Passot G, Gilly FN & Glehen O. Selection of patients and staging of peritoneal surface malignancies. World J Gastrointest Oncol 2, 31–35 (2010).
88. Sugarbaker PH. Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcoma-tosis. Semin Surg Oncol 14, 254–261 (1998).
89. Suzuki A, et al. Value of 18F-FDG PET in the detection of peritoneal car-cinomatosis. Eur J Nucl Med Mol Imaging 31, 1413–1420 (2004).
90. de Bree E, et al. Preoperative computed tomography and selection of pa-tients with colorectal peritoneal carcinomatosis for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol 32, 65–
71 (2006).
91. Jacquet P, Jelinek JS, Steves MA & Sugarbaker PH. Evaluation of com-puted tomography in patients with peritoneal carcinomatosis. Cancer 72, 1631–1636 (1993).
92. Laterza B, Kusamura S, Baratti D, Oliva GD & Deraco M. Role of explor-ative laparoscopy to evaluate optimal candidates for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal mesothelioma. In Vivo 23, 187–190 (2009).
93. Elias D, et al. Comparison of two kinds of intraperitoneal chemotherapy following complete cytoreductive surgery of colorectal peritoneal carcino-matosis. Ann Surg Oncol 14, 509–514 (2007).
94. Frost BM, et al. Increased in vitro cellular drug resistance is related to poor outcome in high-risk childhood acute lymphoblastic leukaemia. Br J Haematol 122, 376–385 (2003).
95. Csóka K, et al. In vitro determination of cytotoxic drug response in ovarian carcinoma using the fluorometric microculture cytotoxicity assay (FMCA).
Int J Cancer 72, 1008–1012 (1997).
96. Sugarbaker PH. Management of Peritoneal Surface Malignancy Using Intraperitoneal Chemotherapy and Cytoreductive Surgery. A Manual for Physicians and Nurses. The Ludann Company: Grand Rapids, MI (1998).
97. Dy GK, et al. Impact of complete response to chemotherapy on overall survival in advanced colorectal cancer: results from Intergroup N9741. J Clin Oncol 25, 3469–3474 (2007).
98. Esquivel J, et al. Accuracy and clinical relevance of computed tomography scan interpretation of peritoneal cancer index in colorectal cancer peritoneal carcinomatosis: a multi-institutional study. J Surg Oncol 102, 565–570 (2010).
99. Klumpp BD, et al. Peritoneal carcinomatosis: comparison of dynamic con-trast-enhanced magnetic resonance imaging with surgical and histopa-thologic findings. Abdom Imaging doi:10.1007/s00261-011-9825-7 (2011) 100. Webb A, et al. The prognostic value of CEA, beta HCG, AFP, CA125,
CA19-9 and C-erb B-2, beta HCG immunohistochemistry in advanced co-lorectal cancer. Ann Oncol 6, 581–587 (1995).
101. Chua TC, Morris DL & Esquivel J. Impact of the peritoneal surface disease severity score on survival in patients with colorectal cancer peritoneal car-cinomatosis undergoing complete cytoreduction and hyperthermic intrap-eritoneal chemotherapy. Ann Surg Oncol 17, 1330–1336 (2010).
102. Verwaal VJ, van Tinteren H, van Ruth S & Zoetmulder FAN. Predicting the survival of patients with peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intraperitoneal che-motherapy. Br J Surg 91, 739–746 (2004).
103. Peduzzi P, Concato J, Feinstein AR & Holford TR. Importance of events per independent variable in proportional hazards regression analysis. II.
Accuracy and precision of regression estimates. J Clin Epidemiol 48, 1503–
1510 (1995).
104. Nordlinger B, et al. Perioperative chemotherapy with FOLFOX4 and sur-gery versus sursur-gery alone for resectable liver metastases from colorectal cancer (EORTC Intergroup trial 40983): a randomised controlled trial.
Lancet 371, 1007–1016 (2008).
105. Mahteme H, Wallin I, Glimelius B, Påhlman L & Ehrsson H. Systemic exposure of the parent drug oxaliplatin during hyperthermic intraperitoneal perfusion. Eur J Clin Pharmacol 64, 907–911 (2008).
106. van Ruth S, Verwaal VJ & Zoetmulder FAN. Pharmacokinetics of intrap-eritoneal mitomycin C. Surg Oncol Clin N Am 12, 771–780 (2003).
107. Elias D, et al. Heated intra-operative intraperitoneal oxaliplatin plus iri-notecan after complete resection of peritoneal carcinomatosis: pharmacoki-netics, tissue distribution and tolerance. Ann Oncol 15, 1558 –1565 (2004).
108. Sugarbaker PH, van der Speeten K, Anthony Stuart O & Chang D. Impact of surgical and clinical factors on the pharmacology of intraperitoneal doxorubicin in 145 patients with peritoneal carcinomatosis. Eur J Surg On-col 37, 719–726 (2011).
109. Mirarabshahii P, Pillai K, Chua TC, Pourgholami MH & Morris DL. Dif-fuse malignant peritoneal mesothelioma - An update on treatment. Cancer Treat Rev doi:10.1016/j.ctrv.2011.10.006 (2011)
110. Cortazar P & Johnson BE. Review of the Efficacy of Individualized Che-motherapy Selected by In Vitro Drug Sensitivity Testing for Patients With Cancer. J Clin Oncol 17, 1625–1625 (1999).
111. Verwaal VJ, Bruin S, Boot H, van Slooten G & van Tinteren H. 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraneal chemotherapy versus systemic chemotherapy in patients with perito-neal carcinomatosis of colorectal cancer. Ann Surg Oncol. 15, 2426–2432 (2008).
112. Chua TC, et al. Influence of modern systemic therapies as adjunct to cy-toreduction and perioperative intraperitoneal chemotherapy for patients with colorectal peritoneal carcinomatosis: a multicenter study. Ann Surg Oncol. 18, 1560–1567 (2011).
113. Pelz JOW, et al. Evaluation of best supportive care and systemic chemo-therapy as treatment stratified according to the retrospective peritoneal sur-face disease severity score (PSDSS) for peritoneal carcinomatosis of colo-rectal origin. BMC Cancer 10, 689 (2010).