The management of peritoneal surface malignancy of colorectal cancer origin

Colorectal carcinomas are predominantly spread malignancies. Peritoneal carcinomatosis frequently associates colorectal carcinomas. The tumour grade, the completeness of cytoreduction, the tumour volume, the presence of distant metastases, prior surgery score and the extent of peritoneal implantations are prognostic clinical features of survival. The management of colorectal cancer with peritoneal carcinomatosis is possible by resection of tumour, cytoreduction and intraperitoneal chemotherapy. T3 and T4 colorectal tumours are at risk of developing locoregional recurrence and may be treated by intraperitoneal chemotherapy. Early postoperative intraperitoneal chemotherapy has been used in 40 patients with T3 and T4 tumours, with 15% hospital mortality, and 32.5% morbidity. The overall 3-year survival rate was over 80% and only 15% distant metastases were recorded.