Peritoneal Carcinomatosis in Patients with Locally Advanced Colon Cancer: Literature Review

Aim: to analyse and systematise available literature data on the diagnosis and treatment of patients with locally advanced colon cancer with peritoneal carcinomatosis. Key points. Even the obvious and rapid progress in the development of surgical and medicinal methods of treating patients with locally advanced colon cancer does not yet guarantee a complete cure. From 4 to 7 % of patients after radical resection report the progression of the disease — peritoneal carcinomatosis. The proportion of patients with isolated peritoneal lesions is about 2 %. This percentage of detection of peritoneal carcinomatosis at an early stage is directly related to the insufficient effectiveness of diagnostic methods, both laboratory and instrumental. To date, surgeons have accumulated quite a wealth of experience in performing diagnostic operations. Laparoscopy is a minimally invasive diagnostic tool and plays an important role in assessing the degree of dissemination, as it allows detailed visualization of the peritoneal surface, performing abdominal biopsies/flushes, and calculating the peritoneal carcinomatosis index (PCI).The issue of early diagnosis of isolated peritoneal carcinomatosis is still relevant. and one of the most accurate methods of diagnosing small-focal peritoneal carcinomatosis is a repeated diagnostic operation (second look). Given the direct relationship between the severity of peritoneal spread and survival, it can be assumed that early detection of peritoneal carcinomatosis will increase the proportion of patients suitable for radical treatment and improve survival. To date, a sufficient number of studies have been conducted comparing the immediate and long-term results of treating patients with colorectal cancer using various combinations of cytoreductive surgery with/without hyperthermic intraperitoneal chemotherapy and/or systemic chemotherapy. Conclusion. Evaluation of the current results of the randomized clinical trials in patients with peritoneal carcinomatosis of colon origin, treated with chemotherapy and in combination with targeted therapy, show fairly good results in overall and relapse-free survival.