Peritoneal carcinomatosis of colorectal origin

Abstract

Peritoneal carcinomatosis is, after liver metastases, the second most frequent cause of death in colorectal cancer patients and at the present time, is commonly inserted and treated as a stage Ⅳ tumour. Because there is no published data that outlines the impact of new therapeutic regimens on survival of patients with peritoneal surface diffusion, the story of carcinomatosis can be rewritten in light of a new aggressive approach based on the combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Also if these treatment perhaps allow to obtain better results than standard therapies, we suggest, that a large prospective randomised control trial is needed to compare long-term and progression-free survival under the best available systemic therapy with or without cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Guidelines on the Use of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Patients with Peritoneal Surface Malignancy Arising from Colorectal or Appendiceal Neoplasms

“…Its origin is often cancers of the gastrointestinal tract, but it can frequently arise from ovarian cancer and breast cancer (mostly the lobular subtype). However, many cancers can metastasize to the peritoneum [1][2][3][4][5][6][7] .…”

Update on Colorectal Carcinomatosis—From Molecular Biology to Diagnosis and Management

“…It is estimated that, at the time of diagnosis, the peritoneal surface is already involved in 10% -15% of cases [2], and that, after CRC curative surgical resection, PC occurs in up to 50% of patients [2,3]: 4% -19% during follow-up time and in almost 44% of the patients who require relaparotomy [4]. In 25% of patients, CRC recurrence is confined to the peritoneal cavity [2,4].…”

“…After liver metastases, PC is the second most frequent cause of death in patients with CRC [1,4] and it is present in 40% -80% of patients who die from CRC [4].…”

Peritoneal carcinomatosis of colorectal origin: is it really an end-stage disease?

“…Remaining microscopic tumor cells should be eradicated immediately after resection with HIPEC. With such an approach, median survival has been reported to reach more than 30 months, with 3-or 5-year survival rates of more than 30 %, in some series [12]. Patient selection is, however, crucial.…”

“…In the absence of prospective studies, the analysis of the French register shows that adjuvant systemic chemotherapy correlates with a better prognosis for the patient, with a median survival of 34 months and a 5-year survival of over 30 % [12].…”