Abstract
Locally advanced colorectal cancer is a challenge for surgeons and medical oncologist;
10 to 20% colorectal cancer debut as locally advanced disease, with tumors extending
through the colon wall with perforation and/or invasion of adjacent organs or structures.
Those locally advanced tumors have a worse prognostic at any stage due not only to
systemic dissemination but also in a high percentage of patients, to locoregional
recurrence, in fact, peritoneal carcinomatosis of colorectal origin is so predictable
that we can assess the risk for each patient according to some histopathological and
clinical features: small peritoneal nodules resected in the first surgery (70% probability),
ovarian metastases (60%), perforated tumor onset or intraoperative tumor rupture (50%),
positive cytology (40%), and pT4/mucinous pT3 up to 40%. Prophylactic or adjuvant
hyperthermic intraperitoneal chemotherapy seems to be a promising strategy for patients
with advanced colorectal cancer to prevent the development of peritoneal recurrence
and improve prognosis of this group of patients.
Keywords
locally advanced colorectal cancer - high-risk patients - peritoneal carcinomatosis
- hyperthermic intraperitoneal chemotherapy
