Management Of Unexpected Peritoneal Metastases With Primary Colorectal Cancer Using Second-Look Surgery With HIPEC

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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