Key Concepts

• Peritoneal dissemination is a frequent occurrence in the natural history of colorectal cancer, which may be synchronous or metachronous.
• The clinical benefit of systemic chemotherapy in patients with colorectal peritoneal metastases is less than in patients with other metastatic sites.
• A substantial survival benefit, with some patients cured, can be achieved in selected patients undergoing CRS and HIPEC.
• Outcome of CRS and HIPEC for colorectal peritoneal metastases is best in patients with low disease burden and complete cytoreduction.
• Currently, a shift in focus is taking place from treatment of established colorectal peritoneal metastases to prevention and early detection, by identification of patients at high risk for developing colorectal peritoneal metastases.
• Combining CRS and HIPEC with limited resection of liver metastases is feasible and achieves good oncological outcomes in a highly selected group of patients.