Modern management of peritoneal carcinomatosis of colorectal origin – Is hyperthermic intraoperative peritoneal chemotherapy the treatment of first choice?

Although cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is still considered as “experimental” by many, there is growing evidence that supports its general use in selective patients with peritoneal carcinomatosis of colorectal origin. The selection of patients remains challenging but is the crucial key to achieve optimal oncological results. Recent studies have shown promising results of systemic chemotherapy with biological agents in the treatment of patients with peritoneal carcinomatosis. Thus, the combination of systemic chemotherapy with CRS and HIPEC could even improve overall survival in affected patients. Future studies are required to evaluate the effectiveness of multimodal therapy and to establish a standardized protocol for the treatment of patients with peritoneal carcinomatosis.