• Delia Cortes-Guiral, Dominique Elias, Pedro Antonio Cascales-Campos, Alfredo Badía Yébenes, Ismael Guijo Castellano, Ana Isabel León Carbonero, José Ignacio Martín Valadés, Jesus Garcia-Foncillas, and Damian Garcia-Olmo.
• Delia Cortes-Guiral, Alfredo Badía Yébenes, Ismael Guijo Castellano, Damian Garcia-Olmo, Department of General Surgery (Peritoneal Surface Surgical Oncolongy), Fundación Jiménez Díaz Hospital, 28050 Madrid, Spain.
• World J. Gastroenterol. 2017 Jan 21; 23 (3): 377-381.

AbstractThe treatment of peritoneal carcinomatosis (PC) of colorectal origin with cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has a 5-year recurrence-free or cure rate of at least 16%, so it is no longer labeled as a fatal disease, and offers prolonged survival for patients with a low peritoneal carcinomatosis index. Metachronous PC of colorectal origin is so predictable that there is a model which has been used to successfully determine the individual risk of each patient. Patients at risk are clearly identified; those with the highest risk have small peritoneal nodules present in the first surgery (70% probability of developing PC), ovarian metastases (60%), perforated tumor onset or intraoperative tumor rupture (50%). Current clinical, biological and imaging techniques still lack sufficient sensitivity to diagnose PC in its initial stages, when CRS plus HIPEC has a greater impact and a higher cure rate. Second-look surgery with HIPEC or prophylactic HIPEC at the time of the first intervention have been proposed as means of preventing and/or anticipating clinical or radiological relapse in at-risk patients. Both techniques have shown a significant decrease in peritoneal relapses and should be considered essential weapons in the management of colorectal cancer.

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