Colorectal cancer and peritoneal carcinomatosis

Colorectal cancer ranks third in new cancer cases and in cancer deaths in men and women combined in the United States. Additionally, the probability of developing an invasive colorectal cancer over one's life-time is around 1 in 16. This amounts to approximately 133,000 new cancer cases and 55,000 cancer deaths yearly. Despite advances in adjuvant therapy for colorectal cancer, the peritoneal surface still remains a considerably high failure site for patients with recurrence of disease. Because of the favorable results of treating peritoneal metastases from ovarian cancer and pseudomyxoma peritonei with cytoreduction and intraperitoneal chemotherapy, this form of therapy has been investigated by several investigators in the management of patients with peritoneal metastases secondary to colorectal cancer. Preliminary studies seem to favor those patients with low-volume, low-grade peritoneal metastases, those with perforated cancers, and those patients in whom definitive cytoreduction is complete. Intraperitoneal chemotherapy with or without hyperthermia is a safe and logical way to administer dose-intensive therapy to the peritoneal cavity.