Surgical Management of Carcinomatosis from Colorectal Cancer
- 1 August 2005
- journal article
- Published by Georg Thieme Verlag KG in Clinics in Colon and Rectal Surgery
- Vol. 18 (03), 190-203
- https://doi.org/10.1055/s-2005-916280
Abstract
Until recently, peritoneal carcinomatosis from colorectal cancer was a universally fatal manifestation of this cancer. However, two innovations in treatment have improved outcome for these patients. The new surgical interventions are collectively referred to as peritonectomy procedures. During these procedures, all visible cancer is removed in an attempt to leave the patient with only microscopic residual disease. Perioperative intraperitoneal chemotherapy, the second innovation, is employed to eradicate small-volume residual disease. The intraperitoneal chemotherapy is administered in the operating room with moderate hyperthermia and is referred to as heated intraoperative intraperitoneal chemotherapy. If tolerated, additional intraperitoneal chemotherapy can be administered during the first 5 postoperative days. The use of these combined treatments, cytoreductive surgery and intraperitoneal chemotherapy, improves survival, optimizes quality of life, and maximally preserves function. This article describes the natural history of colorectal cancer with carcinomatosis, the patterns of dissemination within the peritoneal cavity, and the benefits and limitations of intraperitoneal chemotherapy. Peritonectomy procedures are defined and described. Also presented are the mechanics of delivering perioperative intraperitoneal chemotherapy and the clinical assessments used to select patients who will benefit from combined treatment. The results of combined treatment for colorectal carcinomatosis are presented.Keywords
This publication has 40 references indexed in Scilit:
- Cytoreductive Surgery Combined With Perioperative Intraperitoneal Chemotherapy for the Management of Peritoneal Carcinomatosis From Colorectal Cancer: A Multi-Institutional StudyJournal of Clinical Oncology, 2004
- Carcinomatosis—Is Cure an Option?Journal of Clinical Oncology, 2003
- Peritoneal carcinomatosis from colorectal cancerBritish Journal of Surgery, 2002
- What constitutes good practice in surgical oncology?European Journal of Surgical Oncology, 2001
- Quality of life after intraperitoneal hyperthermic chemotherapy (IPHC) for peritoneal carcinomatosisEuropean Journal of Surgical Oncology, 2001
- Treatment of primary colon cancer with peritoneal carcinomatosisDiseases of the Colon & Rectum, 2000
- Invited Review: For the clinical application of thermochemotherapy given at mild temperaturesInternational Journal of Hyperthermia, 1999
- Prognostic Features of 51 Colorectal and 130 Appendiceal Cancer Patients with Peritoneal Carcinomatosis Treated by Cytoreductive Surgery and Intraperitoneal ChemotherapyAnnals of Surgery, 1995
- Intraperitoneal Hyperthermic Perfusion Combined with Surgery Effective for Gastric Cancer Patients with Peritoneal SeedingAnnals of Surgery, 1988
- Prophylactic therapy for peritoneal recurrence of gastric cancer by continuous hyperthermic peritoneal perfusion with mitomycin CCancer, 1988