TY - CHAP M1 - Book, Section TI - Cytoreductive Surgery and Peritoneal-Based Therapies A1 - Turaga, Kiran K. A2 - Morita, Shane Y. A2 - Balch, Charles M. A2 - Klimberg, V. Suzanne A2 - Pawlik, Timothy M. A2 - Posner, Mitchell C. A2 - Tanabe, Kenneth K. Y1 - 2018 N1 - T2 - Textbook of Complex General Surgical Oncology AB - Peritoneal metastases occur by “seeding” or direct contact unlike the more common hematogenous or lymphatic routes seen in most malignancies. This method of spread leads to considerable challenges in the management of patients due to difficulty in detection and quantification (staging) of burden of disease as there may be no identifiable mass formation on imaging studies. In addition, they can pose technical difficulties in the surgical extirpation of disease given that abdominal viscera are covered by a layer of visceral peritoneum which can be studded with disease. This leads to considerable discomfort and impairment of quality of life of patients via pain, ascites, cachexia, and malignant bowel obstruction, which ultimately leads to inanition and death. The application of cytoreductive surgery (CRS) and intraperitoneal therapies to this disease process offers an attractive method of tumor reduction and drug delivery that could overcome the drawbacks of delivery of intravenous therapy including tumor hypoxia and ischemia, and drug resistance leading to attrition of systemic dosing.1 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/12 UR - hemonc.mhmedical.com/content.aspx?aid=1145763443 ER -