Paul Sugarbaker and his colleagues have persevered in the study and treat ment of peritoneal carcinomatosis. The peritoneal cavity has many unique and incompletely appreciated properties. These properties, coupled with the biologic behavior of many cancers, results in the seeding and growth of these cancers on the peritoneum. Many of these cancers remain localized to the peritoneum only, never metastasizing to other sites. One possible reason for this may be the obstruction of the afferent lymphatics on the undersurface of the diaphragm. The mucopolysaccharides produced by many of these neoplasma are probably viscous enough to obstruct these lymphatics, leading to the syndrome of pseudomyxoma peritonei. Many of the neoplasms taking residence on the peritoneum have extremely long cell-cycle times and are resistant to radiotherapy and many chemotherapeutic agents. How ever, much can be done for these patients - resection of primary cancers, omentectomies to reduce ascites formation, management of recurrent ascites, management of intestinal obstruction, nutritional care, and, hopefully, intraperitoneal chemotherapy. We have reviewed many of these problems in the past [1-7]. Dr. Sugarbaker and his colleagues have organized the current state of knowledge and technology for continuing use. The book provides a basis for thoughtful, prospective research planning. John S. Spratt, M. D. , F. A. C. S. Professor of Surgery The James Graham Brown Cancer Center University of Louisville Louisville, Kentucky References 1. Long RTL, Spratt JS, Dowling E.

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.

Intraperitoneal Cancer Therapy: Principles and Practice is one of the first books to combine the latest clinical developments in the treatment of patients with peritoneal surface disease and the scientific principles that underlie the concept of intraperitoneal cancer therapy. The book covers basic concepts such as anatomy, physiology, pharmacology

This is the first volume to provide a multidisciplinary approach to peritoneal carcinomatosis encompassing molecular mechanisms, histopathology, regional and systemic cytotoxic therapy, and surgical options. Illustrations aid the reader throughout in the many facets of this disease. The book will be of particular interest for medical, surgical and gynecological oncologists faced with the complexities of decision making in patients suffering from PC.

The dissemination of cancer on peritoneal surfaces has hitherto been regarded as a terminal condition. Only a few patients with ovarian cancer - a disease where there is extreme drug sensitivity - have been maintained in a disease-free state over the long term. The tumour biology questions are as follows: Is the dissemination of cancer on peritoneal surfaces to be regarded as finite spread of malignancy, or as evidence of systematic disease? Is peritoneal carcinomatosis in selected patients a limited process that can be treated for cure, using surgery and chemotherapy? Can treatments lead to a complete resolution of the cancerous process? Most oncologists would regard peritoneal carcinomatosis as a condition that can only be palliated. This book presents the principles that support aggressive management plans with disease eradication as an end point.New technologies have emerged, bringing about this conceptual change in thinking. Technologies have been developed for complete chemotherapeutic treatment of all peritoneal surfaces. Technologies have been developed for uncovering minute foci of disease in remote portions of the abdomen. Also, new surgical and electrosurgical techniques are important aspects of this revised management plan. Even the data management tools required to quantitate improvements in treatment have been developed, and are presented here.The book shows that peritoneal carcinomatosis can be treated and that complete eradication of malignancy can occur.

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.