Hidden Opportunities in Cytoreductive Surgery for Peritoneal Carcinomatosis of Colorectal Origin

Excerpt

The optimal management of peritoneal carcinomatosis of colorectal origin remains a challenging clinical problem characterized by more questions than answers. In recent years there has been a great expansion of therapeutic options for patients with metastatic colorectal cancer. Newer and more effective systemic chemotherapeutic agents (e.g., oxaliplatin and irinotecan), targeted biologic therapies (e.g., bevacizumab, cetuximab, panitumumab) and advances in surgical indications for resection of visceral metastases have greatly improved survival outcomes. However, for the more than 15% of patients with colorectal cancer who develop peritoneal metastases, data to guide their therapy are limited, often resulting in treatment decisions based upon strong patient and provider convictions rather than established experimental evidence. …