Clinical management of peritoneal metastases from colorectal cancer
Authors: D. Baratti, Sh. Kusamura, M. Guaglio, M. Deraco
Peritoneal metastases (PM) from colorectal cancer (CRC) were traditionally associated with bad prognosis. Only recently, cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has resulted in survival improvements. We reviewed the currently available literature regarding the clinical management of colorectal PM. The most relevant and recent studies were selected and their findings were discussed. From these series, the weighted median overall survival was 31,6 months (range 16–51). Major morbidity was 17,6–52,4% (weighted average 32,6%). Mortality was 0–8,1% (weighted average 2,9%). Additional relevant topics, such as CRC-PM prevalence, results by systemic therapies, preoperative work-up, and technical aspects were summarized through a narrative review. The recent literature suggests that CRS/HIPEC is gaining acceptance as standard of care for selected CRC-PM patients. Refinement of selection criteria, and rationalization of comprehensive systemic and local-regional management is ongoing. Prevention and early treatment of PM are new and promising options.