Right sided colon cancer and peritoneal carcinomatosis
Peritoneal carcinomatosis is a late manifestation of colon cancer. Patients with right sided colon cancer have increased incidence of peritoneal carcinomatosis compared to those with left sided colon cancers. Conventional intravenous chemotherapy has traditionally been less effective in management of colorectal cancer with peritoneal carcinomatosis. Mucinous histology of the primary colon cancer, more commonly seen with right sided colon cancers, is resistant to chemotherapy and showed more favorable response with aggressive cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemoperfusion (HIPEC). With appropriate preoperative planning, patients that can be treated with complete tumor debulking with CRS have the most favorable outcomes. Development of CRS along with HIPEC in recent years yielded another potential therapy in addition to systemic chemotherapy for management of this disease. Potentially, metastatic peritoneal carcinomatosis can now be treated with CRS and HIPEC in order to achieve long-term survival in carefully selected individuals.