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Review
. 2019 Jul 21;25(27):3484-3502.
doi: 10.3748/wjg.v25.i27.3484.

Colorectal peritoneal metastases: Optimal management review

Juan Manuel Sánchez-Hidalgo  1 , Lidia Rodríguez-Ortiz  2 , Álvaro Arjona-Sánchez  2 , Sebastián Rufián-Peña  2 , Ángela Casado-Adam  2 , Antonio Cosano-Álvarez  2 , Javier Briceño-Delgado  2
Affiliations
Review

Colorectal peritoneal metastases: Optimal management review

Juan Manuel Sánchez-Hidalgo et al. World J Gastroenterol. .

Abstract

The peritoneum is a common site of dissemination for colorrectal cancer, with a poorer prognosis than other sites of metastases. In the last two decades, it has been considered as a locoregional disease progression and treated as such with curative intention treatments. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the actual reference treatment for these patients as better survival results have been reached as compared to systemic chemotherapy alone, but its therapeutic efficacy is still under debate. Actual guidelines recommend that the management of colorectal cancer with peritoneal metastases should be led by a multidisciplinary team carried out in experienced centers and consider CRS + HIPEC for selected patients. Accumulative evidence in the last three years suggests that this is a curative treatment that may improve patients disease-free survival, decrease the risk of recurrence, and does not increase the risk of treatment-related mortality. In this review we aim to gather the latest results from referral centers and opinions from experts about the effectiveness and feasibility of CRS + HIPEC for treating peritoneal disease from colorectal malignancies.

Keywords: Colorectal cancer; Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Peritoneal carcinomatosis; Peritoneal metastases.

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Conflict of interest statement

Conflict-of-interest statement: Any author has any potential conflicts of interest to declare. No financial support was received for this review.

Figures

Figure 1
Figure 1
Peritoneal carcinomatosis index described by Sugarbaker P.
Figure 2
Figure 2
Radiological computed tomography signs for peritoneal disease. Wide green arrow: Omental cake; Thin green arrow: Peritoneal thickening; Green arrow-head: Malignant ascites; Black arrow-head: Peritoneal nodules.
Figure 3
Figure 3
Diffuse miliary carcinomatosis on the small bowel as an example of contraindication for complete cytoreductive surgery.
See this image and copyright information in PMC

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MeSH terms