RT Book, Section
A1 Turaga, Kiran K.
A2 Morita, Shane Y.
A2 Balch, Charles M.
A2 Klimberg, V. Suzanne
A2 Pawlik, Timothy M.
A2 Posner, Mitchell C.
A2 Tanabe, Kenneth K.
SR Print(0)
ID 1145763443
T1 Cytoreductive Surgery and Peritoneal-Based Therapies
T2 Textbook of Complex General Surgical Oncology
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071793315
LK accesssurgery.mhmedical.com/content.aspx?aid=1145763443
RD 2024/04/19
AB Peritoneal  metastases  occur  by  “seeding”  or  direct  contact  unlike  the  more  common  hematogenous  or  lymphatic  routes  seen  in  most  malignancies.  This  method  of  spread  leads  to  considerable  challenges  in  the  management  of  patients  due  to  difficulty  in  detection  and  quantification  (staging)  of  burden  of  disease  as  there  may  be  no  identifiable  mass  formation  on  imaging  studies.  In  addition,  they  can  pose  technical  difficulties  in  the  surgical  extirpation  of  disease  given  that  abdominal  viscera  are  covered  by  a  layer  of  visceral  peritoneum  which  can  be  studded  with  disease.  This  leads  to  considerable  discomfort  and  impairment  of  quality  of  life  of  patients  via  pain,  ascites,  cachexia,  and  malignant  bowel  obstruction,  which  ultimately  leads  to  inanition  and  death.  The  application  of  cytoreductive  surgery  (CRS)  and  intraperitoneal  therapies  to  this  disease  process  offers  an  attractive  method  of  tumor  reduction  and  drug  delivery  that  could  overcome  the  drawbacks  of  delivery  of  intravenous  therapy  including  tumor  hypoxia  and  ischemia,  and  drug  resistance  leading  to  attrition  of  systemic  dosing.1