Peritoneal surface malignancies (PSM) include a heterogeneous group of primary tumors, like peritoneal mesothelioma, and peritoneal metastases from various origins such as ovarian, gastric, colorectal, or appendicular cancers. Their pathophysiology is complex and still not fully elucidated. Historically, due to their dismal prognosis, peritoneal surface malignancies were considered a terminal condition and treated as such in palliative intent.. Surgery has become pivotal in the treatment of PSM and the development of specific techniques of cytoreductive surgery (peritonectomies, “en-bloc” resection) open up a new era of curative intent treatments.

The widespread acceptance among the oncology community at large of cytoreductive surgery and HIPEC as a potentially curative treatment for peritoneal metastases has paved the way for innovative new therapies that could benefit a larger proportion of patients. Much has been and continues to be published on this subject. This book provides comprehensive reviews on the various aspects of managing peritoneal metastases. The authors highlight essential practical issues that surgical oncologists encounter in their day-to-day practice, and try to before provide evidence based answers to address them. All chapters were written and/or reviewed by leading experts in this field.

Included here is a discussion of the pathophysiological aspects and risks of laparoscopic staging (such as trocar metastases) on the basis of international experience.

This book is a state-of-the-art overview of cancer regional therapy (CRT) for the surgeons and interventional radiologists active in CRT development and research. The goals of this book are 1) to review the theory and practice of cancer regional therapies including pharmacology, devices, techniques, and workflow, 2) illustrate the most common procedures performed in the interventional and operating rooms, and 3) discuss data supporting use of CRT. This is meant to be a definitive text on the theory and practice of CRT. It begins with a summary of the history, technical principles that underlie regional therapy. The following parts discuss current data and practice in peritoneal, liver, limb, pleural and other sites. Included in the practice are considerations of workflow and financial issues revolving around CRT. Novel techniques and therapies under investigation are presented to inform the direction of the field. Cancer Regional Therapy summarizes the history, current technology, common procedures, and future prospects in this field and includes procedures from many surgical and interventional radiologic disciplines.

This book provides surgeons and oncologists with a well-founded and detailed overview of the available treatment options for peritoneal malignancy and differential selection of the appropriate forms of therapy. Systemic chemotherapy options are also considered, as are surgical cytoreduction (CRS) and all forms of intraperitoneal chemotherapy (IPC) especially hyperthermic IPC (HIPEC), and immunotherapy, including specific procedures such as PIPAC. Subsequent chapters address perioperative care, complications and recurrences, as well as psycho-oncological, palliative medical and nursing care. The process of parietal and visceral peritonectomy in the large and small intestine is additionally illustrated by three video clips accessible online. Covering a broad range of aspects, including peritoneal metastasis and intraperitoneal chemotherapy, the book offers a valuable tool for surgeons, oncologists and anesthesiologists alike.

This book has been designed to provide the full description of the comprehensive management of peritoneal surface malignancies as a new emerging specialty. Combined treatment of cytoreductive surgery (CRS) and hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) introduced by our leader Paul H. Sugarbaker are performed to treat peritoneal metastases by surgeons all around the world. Therefore this book is focused on detailed surgical anatomy of the peritoneum, preoperative clinical assessment of the peritoneal surface malignancy, patient preparation and operation room equipments, different surgical procedures for CRS and reconstruction, intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and neoadjuvant intraperitoneal chemotherapy, early postoperative intraperitoneal chemotherapy (EPIC) and molecular basis of peritoneal surface malignancies. The chapter on molecular mechanisms of the formation of peritoneal carcinomatosis provides insight into a rapidly expanding knowledge within this speciality. This book should be valuable for surgical oncologists who deal with multimodal treatment for peritoneal surface malignancies, as well as for the trained peritonectomy surgeons. For the senior surgeons, it will also introduce new techniques and approaches in this field such as dealing with the omental cakes and massive organ involvement that requires multi-organ resection.

Gastric cancer has been one of the great malignant scourges affecting man kind for as long as medical records have been kept. Until operative resection pioneered by Bilroth and others became available, no effective treatment was feasible and death from cancer was virtually inevitable. Even with resection by total gastrectomy, the chances of tumor eradication remained small. Over recent years, however, the situation has been changing. Some changes have resulted from better understanding of the disease, early detec tion, and better management techniques with applied clinical research, but the reasons for other changes are poorly understood. For example, the incidence of gastric cancer is decreasing, especially in westernized societies, where it has fallen from one of the most common cancers to no longer being in the top five causes of cancer death. Still it remains the number one killer of adult males in Japan and Korea. Whether the reduced incidence in western societies is a result of dietary changes or methods of food preservation, or some other reason, is as yet uncertain. Improvements in outcome have been reported from mass screening and early detection; more refined techniques of establishing early diagnosis, tumor type, and tumor extent; more radical surgical resection; and resection at earlier stages of disease.