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Management of peritoneal carcinomatosis from colorectal cancer: review of the literature

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Today, we do not have a universally accepted evidence on how to treat peritoneal carcinomatosis (PC) from colorectal cancer (CRC) in international guidelines.

Methods

The present study is a review of the literature investigating current strategies to treat CRC PC.

Results

Despite the progresses of systemic chemotherapy, the presence of PC among patients with metastatic CRC reduces the overall survival to 30 %, and only 4 % of patients with PC from CRC treated are alive for 5 years. Many trials evaluate the combined treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for CRC PC, suggesting a survival benefit in highly selected patients. Only one trial is randomized and presents some biases. The two main prognostic factors are Peritoneal Cancer Index (PCI) and completeness of cytoreduction score (CC score). There is no universal agreement on how to approach the synchronous presence of PC and liver metastasis with a curative intent during the same procedure. A growing interest among the scientific community has arisen about systematic second-look surgery and HIPEC treatment in high-risk patients.

Conclusion

Current evidences suggest that CRS and HIPEC might be beneficial in highly selected patients affected with PC from CRC. Anyway, today, there is a shortage of well-designed phase 3 trials.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Unit of Surgery and Advanced Oncologic Therapies, Morgagni-Pierantoni Hospital, Forlì, Italy

    Carlo Vallicelli, Davide Cavaliere, Massimo Framarini & Giorgio M. Verdecchia

  2. Unit of Emergency Surgery, Maggiore Hospital, Parma, Italy

    Fausto Catena, Hariscine K. Abongwa, Belinda De Simone & Laura Alberici

  3. Unit of General Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy

    Federico Coccolini, Luca Ansaloni & Elia Poiasina

Authors
  1. Carlo Vallicelli
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  2. Davide Cavaliere
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  3. Fausto Catena
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  4. Federico Coccolini
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  6. Elia Poiasina
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  7. Hariscine K. Abongwa
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  8. Belinda De Simone
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  9. Laura Alberici
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  10. Massimo Framarini
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  11. Giorgio M. Verdecchia
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Correspondence to Carlo Vallicelli.

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Vallicelli, C., Cavaliere, D., Catena, F. et al. Management of peritoneal carcinomatosis from colorectal cancer: review of the literature. Int J Colorectal Dis 29, 895–898 (2014). https://doi.org/10.1007/s00384-014-1907-x

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  • DOI: https://doi.org/10.1007/s00384-014-1907-x

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