Current management of peritoneal carcinomatosis from colorectal cancer

摘要: Approximately 5% of colorectal cancer (CRC) patients will develop peritoneal carcinomatosis (PC) in the absence systemic disease. Iconographic staging is only moderately accurate, but may be improved by diffusion weighted MR imaging. Systemic chemotherapy prolongs survival PC patients, less active than with hepatic metastasis. Intraperitoneal based mainly on pharmacokinetic and pharmacodynamic observations. An increasing number treated cytoreductive surgery followed hyperthermic intraperitoneal chemoperfusion (HIPEC). Provided a complete resection can performed, median almost three years achieved. The combined procedure is, however, associated potentially significant morbidity. In resected CRC at high risk recurrence, planned repeat "prophylactic". HIPEC has been shown to significantly reduce recurrence. Cytoreduction should component multimodal approach, including neoadjuvant adjuvant therapeutic regimens. Several questions remain, such as specific role versus alone, results ongoing randomized trials are expected provide important answers.