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Eur J Surg Oncol ; 46(4 Pt A): 675-683, 2020 04.
Article in English | MEDLINE | ID: mdl-31806517

ABSTRACT

The presence of peritoneal metastases in patients with advanced colorectal cancer is associated with poor prognosis but the mechanisms for this are unclear. This review summarises the current knowledge of the pathophysiology, clinical features, prevalence, prognosis, and molecular biology of peritoneal metastases and the risk factors for the development of peritoneal metastases following resection of a primary colorectal tumour. Furthermore, the evidence for treatment strategies are described including cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, early post-operative intraperitoneal chemotherapy, sequential post-operative intraperitoneal chemotherapy and emerging novel strategies. Active areas of research should include the identification of individuals at high risk of peritoneal metastases after curative resection of primary tumour, development of a surveillance program for high-risk patients, optimisation of systematic therapies and further investigation of the use of intraperitoneal chemotherapy.


Subject(s)
Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma/therapy , Colorectal Neoplasms/pathology , Cytoreduction Surgical Procedures , Peritoneal Neoplasms/therapy , Carcinoma/genetics , Carcinoma/secondary , Chemotherapy, Adjuvant , Colorectal Neoplasms/genetics , Humans , Hyperthermia, Induced , Immunotherapy, Adoptive , Infusions, Parenteral , Peritoneal Neoplasms/genetics , Peritoneal Neoplasms/secondary , Prognosis , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins p21(ras)/genetics , Risk Factors
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