Distinct patterns of colorectal peritoneal metastases at initial and repeat cytoreductive surgery

Colorectal cancer rates are continually increasing in Westerncountries exceeding over 3 million new cases annually [1].Hematogenous spread to the liver is the most common meta-static route, followed by transcoelomic dissemination to theperitoneum. Colorectal peritoneal metastases (CRPM) affect5%–8% at the time of initial diagnosis and a further 10%–20%who develop recurrence. Cytoreductive surgery (CRS) is thegold‐standard treatment for selected patients to achievelocoregional control. An even more selective subset undergorepeat CRS (rCRS) for recurrent CRPM to prevent disease‐related morbidity, such as ascites, obstruction, or enteric fistulae, extending median survival by 20–62 months.