1;Preface;5 2;Table of Contents;9 3;List of Contributors;11 4;1 Management of Peritoneal Surface Malignancy: A Short History;14 4.1;1.1 Introduction;14 4.2;1.2 Peritoneal Space to Plasma Barrier;14 4.3;1.3 A Requirement for Complete Cytoreduction Using Peritonectomy Procedures;15 4.4;1.4 Long-Term Intraperitoneal Chemotherapy;15 4.5;1.5 Early Postoperative Intraperitoneal Chemotherapy;16 4.6;1.6 Heated Intraoperative Intraperitoneal Chemotherapy;16 4.7;1.7 More Knowledgeable Use of Quantitative Prognostic Indicators for Combined Treatment;17 4.8;1.8 Development of Peritoneal Surface Oncology Treatment Centers;18 4.9;1.9 Future Directions;18 4.10;1.10 Respect for the Peritoneum as a First Line of Defense of Carcinomatosis;18 4.11;References;20 5;2 The Natural History of Free Cancer Cells in the Peritoneal Cavity;23 5.1;2.1 Molecular Mechanisms Involved in Peritoneal Dissemination;23 5.2;2.2 Detection of Free Cancer Cells in the Peritoneal Cavity;30 5.3;2.3 Clinical Implications and Signifificance of a Positive Cytology;31 5.4;References;33 6;3 Pathological Evaluation and Implications of Serosal Involvement in Gastrointestinal Cancer;36 6.1;3.1 Introduction;36 6.2;3.2 Anatomy and Microanatomy;36 6.3;3.3 Defifinition and Pathological Evaluation of Serosal Involvement;37 6.4;3.4 Cytological Assessment of Serosal Involvement;39 6.5;3.5 Signifificance of Serosal Involvement;40 6.5.1;3.5.1 Oesophagus;40 6.5.2;3.5.2 Stomach;41 6.5.3;3.5.3 Small Intestine;42 6.5.4;3.5.4 Appendix;42 6.5.5;3.5.5 Colon;44 6.5.6;3.5.6 Rectum;45 6.6;3.6 Summary and Conclusions;46 6.7;References;47 7;4 Principles of Perioperative Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis;50 7.1;4.1 The Rationale for Intraperitoneal Chemotherapy;50 7.2;4.2 The Pharmacokinetic Advantage;50 7.3;4.3 Drug Tissue Distribution and Tumour Penetration Depth;52 7.4;4.4 Timing of Intraperitoneal Chemotherapy;53 7.5;4.5 Hyperthermia;53 7.5.1;4.5.1 Direct Cytotoxic Effect of Hyperthermia;53 7.5.2;4.5.2 Thermal Enhancement of Chemotherapeutic Drugs;55 7.5.3;4.5.3 Tissue Penetration Depth of Hyperthermia During HIPEC;56 7.6;4.6 Drug Choice;56 7.7;4.7 Carrier Solutions;57 7.8;4.8 Duration of Hyperthermic Chemoperfusion;59 7.9;References;60 8;5 Experimental and Pharmacokinetic Studies in Intraperitoneal Chemotherapy: From Laboratory Bench to Bedside;63 8.1;5.1 Alkylating Agents;64 8.1.1;5.1.1 Melphalan;64 8.1.2;5.1.2 Cyclophosphamide and Ifosfamide;65 8.1.3;5.1.3 Mitomycin C;65 8.2;5.2 Platinum Derivatives;66 8.2.1;5.2.1 Cisplatin;66 8.2.2;5.2.2 Carboplatin;67 8.2.3;5.2.3 Oxaliplatin;68 8.3;5.3 Anthracyclins;69 8.3.1;5.3.1 Adriamycin;69 8.3.2;5.3.2 Mitoxantrone;70 8.4;5.4 Antimetabolites;70 8.4.1;5.4.1 Methotrexate;70 8.4.2;5.4.2 5-Fluorouracil and Floxuridine;71 8.4.3;5.4.3 Gemcitabine;72 8.5;5.5 Topoisomerase Inhibitors;73 8.5.1;5.5.1 Irinotecan;73 8.5.2;5.5.2 Topotecan;73 8.5.3;5.5.3 Etoposide;74 8.6;5.6 Taxanes;74 8.6.1;5.6.1 Paclitaxel;74 8.6.2;5.6.2 Docetaxel;75 8.7;5.7 Conclusions and Future Directions;76 8.8;References;77 9;6 Technology for the Delivery of Hyperthermic Intraoperative Intraperitoneal Chemotherapy: A Survey of Techniques;84 9.1;6.1 Introduction;84 9.2;6.2 Technique of Intraperitoneal Hyperthermic Chemoperfusion;84 9.3;6.3 Closed Technique;85 9.4;6.4 Open Abdomen (Coliseum) Technique;86 9.5;6.5 Peritoneal Cavity Expander Technique;88 9.6;6.6 Developing a HIPEC Program;89 9.7;6.7 Summary;90 9.8;References;91 10;7 Adjuvant Intraperitoneal Chemotherapy: A Review;92 10.1;7.1 Introduction;92 10.2;7.2 Gastric Cancer;92 10.3;7.3 Colorectal Cancer;95 10.4;7.4 Ovarian Cancer;96 10.5;7.5 Conclusion;97 10.6;References;97 11;8 Clinical Research Methodology in Peritoneal Surface Oncology: A Diffificult Challenge;99 11.1;8.1 Preoperative Variables;99 11.2;8.2 Peroperative Variables;100 11.2.1;8.2.1 Concerning the Peroperative Description of PC;100 11.2.2;8.2.2 Concerning the Completeness of Cytoreduction;102 11.3;8.3 HIPEC Variables;103 11.4;8.4 Postoperative Variabl