, Volume 14, Issue 11, pp 3037-3039,
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Date: 29 Aug 2007

Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Colorectal Carcinomatosis: If at First You Don't Succeed...

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The management and outcomes of stage IV colorectal cancer have changed significantly over the past 5–10 years. The advent of relatively effective, multimodality regimens of 5-fluorouracil and leucovorin combined with cytotoxic agents (e.g., oxaliplatin or irinotecan) and targeted therapies (e.g., bevacizumab or cetuximab) has resulted in unprecedented rates of both tumor response and patient survival.1,2 Simultaneously the indications for surgery in the management of hepatic and pulmonary metastases from colorectal cancer continue to expand. However, for patients with carcinomatosis from colorectal cancer, the view remains generally nihilistic for a number of reasons. First, the historical life expectancy of patients with colorectal carcinomatosis was a dismal 6–7 months.3 Second, surgery has traditionally not been shown to play any significant role other than selective palliation. Third, despite the overall results of the more efficacious chemotherapy regimens, the actual benefit to p ...