Cytoreductive surgery using peritonectomy and visceral resections for peritoneal surface malignancy

As cancer surgery expanded in the midst of a technological revolution in patient care, this discipline accepted responsibilities not only for the resection of primary tumor but also the surgical management of metastatic disease. Aggressive management strategies to bring about long-term survival to patients with peritoneal surface malignancy have been pioneered by our group (1,2). Successful treatment of abdominal and pelvic malignancies that disseminate to peritoneal surfaces has resulted from extensive experience with appendiceal cancer. Appendiceal cancer became the paradigm for successful treatment of peritoneal metastases (PM) (3,4). This review presents the concepts for and the technique of cytoreduction that prepares the patient for chemotherapy used in the operating room with hyperthermia with acceptable morbidity and mortality.