Director of the Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, D.C., USA

Paul H. Sugarbaker initiated several projects concerning metastatic disease from gastrointestinal and gynecologic cancer in the decades between 1994 and 2024. At the Surgery Branch, National Cancer Institute, he initiated surgical technologies to safely resect liver metastases and determine that a long-term survival occurred in approximately one-third of the patients. Another pattern of metastatic disease was peritoneal metastases. This clinical diagnosis was, at that time, universally fatal. The only treatment was palliative systemic chemotherapy which was rarely beneficial. Early efforts using resection alone were of limited benefit but offered promise of success with continued local-regional treatment strategies. After combined treatment with cytoreductive surgery using peritonectomy and visceral resections and perioperative chemotherapy, the outcomes dramatically changed. A huge success with combined treatment of the mucinous appendiceal neoplasms was reported. Patients who were routinely considered terminal and having no viable treatment options were showing a survival greater than 80% at 10 years.

The strategy was applied to malignant peritoneal mesothelioma, ovarian cancer, gastric cancer, and colorectal cancer peritoneal metastases. He has worked over the last five decades to make progress in the prevention and treatment of peritoneal metastases. Approximately 2000 treatment centers are currently operational and achieving great success around the globe. He has brought into this effort all the disciplines within oncology to maximize benefits. The gynecologic malignancies appear to be included in the global success story regarding prevention and treatment of peritoneal metastases. Our Nova Science Publishers has printed the current “State of the Art” in the optimal use of cytoreductive surgery and perioperative chemotherapy for peritoneal surface malignancy of gynecologic origin.