Resectional treatment of peritoneal carcinomatosis followed by intraperitoneal chemotherapy, practical aspects

Surgical resection with curative intent for peritoneal carcinomatosis (PC) requires the excision of all macroscopic disease followed by immediate intraperitoneal chemotherapy to treat the residual microscopic metastases. Hyperthermia improves the effectiveness of this approach. The techniques for excision of PC are rather specific and are not undertaken unless it is possible to remove all visible disease larger than 1 mm. and to assure a post-operative quality of life which is more or less normal. Intraperitoneal hyperthermic chemotherapy techniques must be draconian in order to be effective. If these conditions can be met, peritoneal metastases can be definitively cured in two thirds of colorectal PC and pseudomyxoma peritonei, and in nearly half of mesotheliomas.