Should Patients With Peritoneal Carcinomatosis of Colorectal Origin With Synchronous Liver Metastases Be Treated With a Curative Intent? A Case-Control Study

Maggiori, Léon; Goèré, Diane; Viana, Benjamin; Tzanis, Dimitrios; Dumont, Frédéric; Honoré, Charles; Eveno, Clarisse; Élias, Dominique

doi:10.1097/sla.0b013e3182778089

Cited by 92 publications

(76 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A meta-analysis conducted by Dutch investigators showed a trend toward lower OS after curative resection plus HIPEC in patients with CRC metastases in the liver, as well as in the peritoneum, than in patients with peritoneal metastases alone after the same treatment [48]. Although this approach can be used to treat PC and liver metastases during the same procedure in selected patients, only patients who have limited peritoneal spread (PCI < 12) and a limited extent of liver disease (liver metastases < 3) really benefit from this approach, with a median survival of 40 months [49].…”

Section: Extent Of Diseasementioning

confidence: 96%

Patient Selection for Treatment

Sammartino

Accarpio²,

Sollazzo³

et al. 2015

Treatment of Peritoneal Surface Malignancies

View full text Add to dashboard Cite

Section: Extent Of Diseasementioning

confidence: 96%

Patient Selection for Treatment

Sammartino

Accarpio²,

Sollazzo³

et al. 2015

Treatment of Peritoneal Surface Malignancies

View full text Add to dashboard Cite

“…However, because the prognosis for colorectal cancer patients with limited resectable liver metastases after hepatic surgery and current chemotherapeutic regimens is reasonable, some centres will use liver surgery, crs, hipec, and systemic chemotherapy to treat patients with up to 3 peripherally localized and resectable liver metastases and limited ptc. The morbidity and long-term results in such patients are not different from those of colorectal ptc patients without liver metastases (to be discussed shortly) [12][13][14] . Infiltration of the liver capsule by peritoneal tumour should be differentiated from parenchymal liver metastases.…”

Section: Patient Selectionmentioning

confidence: 99%

“…As already discussed, patients with limited ptc and fewer than 3 resectable liver metastases can also be good candidates for hipec, with a reasonable possibility of achieving prolonged survival [12][13][14] .In a recent case-control study 13 , 37patients with ptc and liver metastases were matched with 61 patients having ptc alone. All underwent crs, resection of liver metastases (when present), and hipec.…”

Section: Colorectal Cancermentioning

confidence: 99%

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

2016

View full text Add to dashboard Cite

Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locoregional treatment for selected patients with ptc from gastric, colorectal, and ovarian cancer; with mesothelioma; and with pseudomyxoma peritonei. In the prophylactic setting, hipec can also be used to prevent ptc in high-risk patients, and the first results of the "second-look" approach are promising. Patient selection-in which the risks of perioperative morbidity and mortality, which are analogous to those for any other major gastrointestinal surgery, are assessed-is of utmost importance. Those risks have to be weighed against the anticipated survival benefit, which depends mainly on tumour biology, extent of disease, and probability of achieving complete crs. The present review discusses the principles of crs and hipec, the most significant recent clinical data, and current perspectives concerning the application of this treatment modality in various malignancies. Ongoing trials and future directions are noted. It appears that the combination of crs and hipec is an indispensable tool in the oncologist's armamentarium.

show abstract

“…In terms of a surgical approach, CRC for oligometastastic diseaseonly patients should be discussed only for those with a PCI < 12, who have no SC [39], and who are responsive to preoperative chemotherapy. Patients with small bowel involvement [40] and more than three liver metastases [41] should be excluded from surgical treatment.…”

Section: Summary Of Oligometastases From Colorectal Cancermentioning

confidence: 99%

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

Rau¹,

Brandl²,

Pascher³

et al. 2017

Visc Med

View full text Add to dashboard Cite

Objectives: Treatment options for patients with gastrointestinal cancer and oligometastastic disease remain the domain of the medical oncologist. However, in selected cases, attempts to remove or destroy the tumor burden seem appropriate. Background Data: During the last decade, the treatment of localized and isolated tumor nodules, such as lung, liver or peritoneal metastasis, has changed. Previously, these patients with metastatic disease only received palliative chemotherapy. Combined treatment approaches and new techniques demonstrate that additional surgery to destroy or remove the metastases seem to be of major benefit to patients. Methods: The recently published important literature regarding peritoneal metastases and oligometastases in gastrointestinal cancer was analyzed. Results: The most important factor in the treatment of peritoneal metastases and in cytoreductive surgery is patient selection. Resection of peritoneal metastases should be considered. Hyperthermic intraperitoneal chemotherapy is feasible. However, further results of randomized trials are necessary. Several randomized trials are on the way and will be available in 1-2 years. Systemic chemotherapy alone as an adequate management plan for all sites of metastatic disease is not compatible with a high standard of care. Formulating an optimal plan combining re-operative surgery with regional plus systemic chemotherapy is a necessary task of the multidisciplinary team. Conclusions: In oligometastastic disease of gastrointestinal cancer origin, the selection process is the most important factor for survival. Further studies are needed to determine optimal treatment options.

show abstract

Should Patients With Peritoneal Carcinomatosis of Colorectal Origin With Synchronous Liver Metastases Be Treated With a Curative Intent? A Case-Control Study

Abstract: This case-control study seems to confirm that prolonged survival can be achieved in highly selected patients operated on for limited PC and fewer than 3 LM.

Cited by 92 publications

References 26 publications

Patient Selection for Treatment

Patient Selection for Treatment

Treatment of Peritoneal Surface Malignancies with Hyperthermic Intraperitoneal Chemotherapy—Current Perspectives

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

Contact Info

Product

Resources

About