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Summary of current therapeutic options for peritoneal metastases from colorectal cancer

Authors

  • Terence C. Chua BscMed (Hons), MBBS,

    1. Hepatobiliary and Surgical Oncology Unit, Department of Surgery, University of New South Wales, St George Hospital, Sydney, Australia
    2. Department of Surgical Oncology, St Agnes Hospital, Baltimore, Maryland
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  • Jesus Esquivel MD,

    1. Department of Surgical Oncology, St Agnes Hospital, Baltimore, Maryland
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  • Joerg O.W. Pelz MD,

    1. Department of Surgery, University of Wuerzburg, Wuerzburg, Germany
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  • David L. Morris MD, PhD

    Corresponding author
    1. Hepatobiliary and Surgical Oncology Unit, Department of Surgery, University of New South Wales, St George Hospital, Sydney, Australia
    • Professor, Department of Surgery, St George Hospital, University of New South Wales, Kogarah, NSW 2217 Sydney, Australia. Fax: +61-2-9113-3997.===

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Abstract

Background

Peritoneal metastases remain an under addressed problem for which this review serves to investigate the efficacy of systemic chemotherapy and radical surgical treatments in this disease entity.

Methods

The literature between 1995 and June 2009 was surveyed systematically through a review of published studies on the treatment outcomes of metastatic colorectal cancer to the peritoneum on the Medline and PubMed databases.

Results

A total of 2,492 patients from 19 studies were reviewed. One thousand and eighty-four patients treated with complete cytoreductive surgery (CCS) and hyperthermic intraperitoneal chemotherapy (HIPEC) and 1,408 patients were treated with palliative surgery and/or systemic chemotherapy. For CCS HIPEC, the overall survival ranged between 20 and 63 (median 33) months, and 5-year survival ranged between 17% and 51% (median 40%). For palliative surgery and/or systemic chemotherapy, the overall survival ranged between 5 and 24 (median 12.5) months, and 5-year survival ranged between 13% and 22% (median 13%).

Conclusion

Systemic therapies have not proved effective and randomised clinical trials have not sufficiently addressed patient subpopulations with metastatic disease of this entity. Current evidence have demonstrated the efficacy associated with CCS HIPEC for which should now be embraced as the standard of care. J. Surg. Oncol. 2013;107:566–573. © 2012 Wiley Periodicals, Inc.

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