Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer

Abstract

Despite potentially curative surgical removal of gastrointestinal (GI) cancers, over 50 o of patients eventually die of their disease. The mechanisms behind GI cancer recurrence have not been convincingly described. The resection site and peritoneal surfaces are extremely common sites of GI cancer recurrence. It seems unlikely that disease spread to the tumor bed and to peritoneal surfaces occurs preoperatively. No cancer can be appreciated by direct visualization of these anatomic sites at the time of surgery. The most common locations for GI cancer recurrence, the resection site and peritoneal surfaces, are involved not by preoperative but by intraoperative and perioperative tumor dissemination.