Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy
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Malignancy- A 56-year-old woman presents for evaluation of increasing abdominal girth, fullness, and abdominal pain. On examination, her abdomen is distended and she has had progressive weight loss of 50 lbs over the last 1 year. Computed tomography is performed (Figure). Her gynecologic examination and transvaginal ultrasonography findings are normal. Findings of colonoscopy are unremarkable. What is the best step in management?
- You are consulted by the emergency department about a patient with a large bowel obstruction caused by an obstructing right colonic mass. On exploration, you note that she has peritoneal carcinomatosis in the right lower quadrant, with a normal-appearing liver and ovaries. You perform a right colectomy with primary anastomosis, and a biopsy of her metastatic disease. Final pathology report is consistent with metastatic appendiceal mucinous neoplasm. Staging shows no evidence of distant metastatic disease aside from her known isolated peritoneal lesions. What is the best treatment option to improve her overall survival?