Peritoneal metastases (PM) will be
unexpectedly present in approximately 10% of colorectal cancer patients having
primary cancer resection. In the past this was considered to be an incurable
condition with a terminal outcome.
In patients determined to have peritoneal
dissemination at the time of resection, the intervention
was considered palliative. Recently, long term benefit from definitive
treatment of PM with cytoreductive surgery (CRS) and hyperthermic
intraperitoneal chemotherapy (HIPEC) has become a reality.
These treatments are now appropriate for
primary appendiceal and colorectal cancer determined to have PM at the time of
resection.Modifications of the initial management of colorectal cancer patients
found upon exploration to have PM are explored in this manuscript. In these
patients, not only the primary cancer but also the PM must be optimally
treated.
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