BACKGROUND: Peritoneal recurrences after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer are challenges in conservative and surgical oncology. METHODS: Surgical concepts are discussed in this review on the basis of the current literature. RESULTS: The majority of patients suffer from recurrent disease after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer. In most cases, a palliative chemotherapy is performed. Repeated surgery with the aim of complete cytoreduction may be done in selected cases. CONCLUSIONS: New concepts are necessary to treat patients with recurrent disease as early as possible.
