Endoreduction

Endoreduction is a surgical term used in oncology to describe the debulking or reduction of tumor burden within a body cavity or organ. The goal is to remove as much gross tumor as possible to improve symptoms and enable additional therapies, such as chemotherapy or intraperitoneal treatment. The exact definition and scope of endoreduction can vary by specialty, and some clinicians use the term interchangeably with cytoreductive or debulking procedures, while others reserve it for intraperitoneal or intra-organ debulking maneuvers.

Scope and practice vary, but endoreduction is commonly discussed in the context of peritoneal surface malignancies and other cancers with diffuse intra-abdominal spread. Procedures may involve removing large tumor masses, resecting affected sections of organs, and performing selective organ-sparing resections when feasible. The emphasis is on achieving the greatest possible reduction of visible disease while preserving function and minimizing operative risk. The extent of resection is guided by disease distribution, patient fitness, and the anticipated impact on subsequent therapies.

Outcomes are highly dependent on disease type, extent, and the use of multimodal treatment. Endoreduction can alleviate symptoms and, in appropriately selected patients, contribute to prolonged progression-free survival when combined with systemic chemotherapy or regional therapies such as intraperitoneal chemotherapy. However, the approach carries substantial risks, including bleeding, infection, organ injury, and postoperative complications. As with other debulking strategies, endoreduction is not curative in most advanced cancers and requires careful patient selection and multidisciplinary planning.

See also: cytoreductive surgery, debulking, intraperitoneal chemotherapy.