Revura A. Cytoreductive surgery in surgical treatment of patients with colorectal cancer and peritoneal carcinomatosis

This research focuses on evaluation of the efficacy of cytoreductive surgery in patients with colorectal cancer and peritoneal carcinomatosis, on the study of diagnostic value of computed tomography for the estimation of disease spread and choice of treatment and on identification of risk factors for peritoneal carcinomatosis taking into account the morphological features of the tumor. Age of less than 60 years, tumor invasion of serous layer of the bowel wall and tumor histological type of mucinous adenocarcinoma were found to be risk factors for developing metachronous peritoneal carcinomatosis in patients with colorectal cancer. Multi-slice spiral computed tomography is the method of choice for the diagnosis of peritoneal carcinomatosis that allows to determine indications for cytoreductive surgery. Based on the analysis of long-term results of surgical treatment it was shown that cytoreductive surgery followed by systemic chemotherapy is recommended to carry out in patients with colorectal cancer and peritoneal carcinomatosis without extraperitoneal metastases, with PCI 1–10 and when complete cytoreduction is possible to be performed. Cytoreductive surgery features an acceptable level of postoperative complications and mortality and allows to significantly improve long-term survival compared with palliative chemotherapy.