Association between pelvic exenteration and hyperthermic intraperitoneal chemotherapy for rectal cancer

Colorectal cancer spreads via multiple pathways, the most commonly encountered ways being represented by the peritoneal and hematogenous ones as well as by direct contiguity. At this time significant benefits in terms of survival have been reported in cases presenting locally advanced lesions and for those presenting extended peritoneal lesions of peritoneal carcinomatosis especially if radical resection is achievable. In this respect, certain authors went further and investigated whether the association of the two surgical strategies – extended pelvic resections and cytoreductive surgery of the peritoneal metastases could improve survival in cases in which both patterns of spread are present. Meanwhile, the possibility of association of hyperthermic intraperitoneal chemotherapy (HIPEC) was also investigated. The aim of the current study is to review and analyze the most relevant studies conducted on this issue.