Peritoneal Metastases from Colorectal Cancer: Treatment Principles and Perspectives.

Peritoneal metastases are the third most common site of recurrence of colorectal cancer. Diagnosis is difficult and often made at an advanced stage even on imaging. Curative treatment relies on complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC), which dramatically improves survival in selected patients. Main prognostic factors are based on the extent of the peritoneal disease and the completeness of surgery. Therefore, identifying patients at high risk of developing peritoneal metastases with the aim of diagnosing and treating patients at an early stage appears crucial. Proactive attitude and prophylactic treatment based on HIPEC are being evaluated on clinical trials.