Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

SIMPLE SUMMARY: Peritoneal cancer is best addressed by a multimodal treatment approach, including cytoreductive surgery, systemic immunochemotherapy, and intraperitoneal chemotherapy (HIPEC, PIPAC). The present Swiss Peritoneal Cancer Group comprehensive treatment algorithms offer consensus guidance for interdisciplinary care of patients with peritoneal cancer from pseudomyxoma peritonei, peritoneal mesothelioma, gastric, and colorectal origin. They include straight complete surgical resection, multimodal neoadjuvant treatment, HIPEC and PIPAC, and referral to palliative care. These state-of-the-art algorithms have been endorsed by all Swiss clinicians routinely involved in the multimodal care of patients with peritoneal cancer of gastrointestinal origin. ABSTRACT: Peritoneal cancer (PC) is a dire finding, yet in selected patients, long-term survival is possible. Complete cytoreductive surgery (CRS) together with combination immunochemotherapy is essential to achieve cure. Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are increasingly added to the multimodal treatment. The Swiss Peritoneal Cancer Group (SPCG) is an interdisciplinary group of expert clinicians. It has developed comprehensive treatment algorithms for patients with PC from pseudomyxoma peritonei, peritoneal mesothelioma, gastric, and colorectal origin. They include multimodal neoadjuvant treatment, surgical resection, and palliative care. The indication for and results of CRS HIPEC and PIPAC are discussed in light of the current literature. Institutional volume and clinical expertise required to achieve best outcomes are underlined, while inclusion of patients considered for CRS HIPEC and PIPAC in a clinical registry is strongly advised. The present recommendations are in line with current international guidelines and provide the first comprehensive treatment proposal for patients with PC including intraperitoneal chemotherapy. The SPCG comprehensive treatment algorithms provide evidence-based guidance for the multimodal care of patients with PC of gastrointestinal origin that were endorsed by all Swiss clinicians routinely involved in the multimodal care of these challenging patients.