Inadvertent excision of malignant soft tissue tumours

Inadvertent excision of lumps which turn out to be sarcomas is not uncommon. Imaging has a limited role in detecting microscopic residual disease but can show the extent of the previous surgical field. Standard treatment is wide re-excision, usually combined with radiotherapy. Residual tumour is found in an average of 50% of reported cases. The presence of residual disease is an adverse prognostic factor. All lumps bigger than a golf ball should have a diagnosis prior to excision. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180060

Cytoreductive Surgery and Hyperthermic Chemotherapy Role in Peritoneal Carcinomatosis Treatment

The aim of this article is to provide a review of some current therapeutic strategies for patients with peritoneal carcinomatosis (PC), which historically has been considered a terminal condition, only amenable to palliative care, and occasionally systemic chemotherapy alone with poor response and lower average survival. The combination of cytoreductive surgery (CRS), which involves peritonectomy and multivisceral resections and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is a relatively new intraperitoneal treatment of microscopic residual disease concept. The indication of this method has been extended progressively to highly selected patients with PC and it is based in several phase III studies, which concluded that it is possible to obtain sufficient cytoreduction. However, until now there is some consensus based on evidence, in which HIPEC would be indicated in patients with peritoneal PC originated in pseudomyxoma, peritoneal mesothelioma and colorectal cancer; and CP from another source, depending on each particularcase.