title: Peritoneal cancer treatment.
abstract: BACKGROUND
  In the past, peritoneal surface malignancy (PSM) was considered as a final stage of cancer, and patients were offered the best supportive care. Recently, a new therapeutic alternative approach based on the combination of surgery with chemotherapy was developed. In this curative intent, the macroscopic disease was treated with cytoreductive surgery (CRS) combined with perioperative chemotherapy, including neoadjuvant chemotherapy, hyperthermic intraoperative intraperitoneal chemotherapy, extensive intraoperative peritoneal lavage and early postoperative intraperitoneal chemotherapy
  
  
  METHODS
  This article reviews the mechanisms of the formation of PSM, quantitative estimation of PSM and residual disease, multimodal treatment, value of laparoscopy, prognostic factors and patients' selection for the multimodal therapy.
  
  
  CONCLUSIONS
  Recent studies show that CRS plus intraperitoneal chemotherapy applications confer prolonged survival in patients with PSM from colorectal, gastric, ovarian, appendiceal mucinous carcinoma and diffuse malignant peritoneal mesothelioma. The comprehensive treatment is now justified as state-of-the-art for patients with peritoneal metastasis.
authors.affiliation: NPO Organization to Support Peritoneal Surface Malignancy Treatment , Oosaka , Japan y.yonemura@coda.ocn.ne.jp.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Emel
authors.initials: E
authors.lastname: Canbay
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Endou
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Mizumoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Miura
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Takeshita
authors.forename: Masumi
authors.initials: M
authors.lastname: Ichinose
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takao
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hirano
authors.forename: Shouzou
authors.initials: S
authors.lastname: Sako
authors.forename: Gorou
authors.initials: G
authors.lastname: Tsukiyama
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual; D010533:Peritoneal Lavage; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*