| Abstract: |
Peritoneal carcinomatosis is a common progression of colorectal cancer with poor prognosis for many patients. Though the advent of modern chemotherapy and biologic treatments has resulted in improved survival for patients with advanced colorectal cancer, patients with peritoneal carcinomatosis have shown worse response to systemic chemotherapy and improvement in their overall and disease-free survival lags behind those with liver and lung metastases. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer represent an important regional approach adjuvant therapy. Though few randomized studies exist, case report and case-control studies continue to demonstrate better than expected survival in select patients with peritoneal carcinomatosis from colorectal cancer when compared to historical controls. Though morbidity and mortality of cytoreductive surgery and HIPEC for advanced colorectal cancer remain high, it is within a range established for other interventions for advanced cancers and has been shown to improve with increased surgeon and institution experience. Though HIPEC was initially introduced for the management of established peritoneal carcinomatosis, ongoing research into adjuvant HIPEC at the time of curative surgery in patients with locally advanced tumors and HIPEC paired with planned second-look surgery in high-risk patients with advanced minimally metastatic disease suggests HIPEC may have an expanded role in the management of advanced colorectal cancer. © Springer Nature Switzerland AG 2020. All rights reserved. |
