Multidisciplinary treatment of colorectal cancer peritoneal metastasis / 中国癌症杂志

ABSTRACT

Peritoneum is one of the common site of colorectal cancer metastasis. Traditionally, peritoneal carcinomatosis is associated with a poor prognosis without effective surgical treatment. Recently, the attitude towards the treatment strategies for colorectal peritoneal metastasis has changed significantly with advances in surgical techniques, hyperthermic intraperitoneal chemotherapy and multi-disciplinary treatment. As to the prognosis, colorectal peritoneal metastasis has an inferior outcome to non-peritoneal metastasis under the palliative systemic treatment. However, the complete peritoneal cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can achieve a long-term survival in selective patients with colorectal peritoneal metastasas. The prognostic factors include peritoneal carcinomatosis index, completeness of cytoreduction, the presence of extra-peritoneal metastasis (liver etc), peritoneal surface disease severity score and Japanese peritoneal staging. In terms of the treatment, complete peritoneal cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and systemic treatment (including chemotherapy and targeted therapy) may be the best modality of multi-disciplinary treatment for colorectal peritoneal metastasis.