A new standard of care for the management of peritoneal surface malignancy.

Cancer dissemination to peritoneal surfaces was, in the past, a lethal condition with a limited survival. Clinical and pharmacologic research have shown that options for both treatment and prevention are now reality. The diseases most commonly treated include peritoneal dissemination from appendiceal malignancy, colorectal malignancy, and peritoneal mesothelioma. Selection factors are important to minimize the number of treated patients who will experience short-term benefit. Treatments involve cytoreductive surgery and perioperative chemotherapy. The intraperitoneal chemotherapy in the operating room is used with heat. Although this combined approach has been criticized, the informed oncologist will seek to identify those patients that may benefit from this more optimistic concept of peritoneal dissemination of cancer.