ABSTRACT
Oncology as a surgical subspecialty evolved in the midst of a technological revolution in patient care. This discipline expanded from the resection of primary cancer to include the surgical management of metastatic disease. The earliest success with this new concept was with complete resection of locally recurrent colon and rectal cancer.1,2 Then the resection of liver metastases from the same disease was shown to be of benefit in a selected group of patients.3
Extension of the concept of complete surgical eradication of metastatic disease to bring about long-term survival to patients with peritoneal surface malignancy has been pioneered by our group.4,5 Appendix cancer is the paradigm for successful treatment of peritoneal carcinomatosis6 (see also Chapter 31). The present chapter presents the background, the standardized treatments currently in use, and the selection factors leading to long-term survival with acceptable morbidity and mortality. It is our opinion that prevention and treatment of peritoneal surface dissemination of colon cancer is a surgical responsibility that produces great benefits at acceptable risk and cost.
