Progress in treatments for colorectal cancer peritoneal metastases during the years 2010-2015. A systematic review

Dario Baratti; Shigeki Kusamura; Filippo Pietrantonio; Marcello Guaglio; Monica Niger; Marcello Deraco

doi:10.1016/j.critrevonc.2016.01.017

Progress in treatments for colorectal cancer peritoneal metastases during the years 2010-2015. A systematic review

Crit Rev Oncol Hematol. 2016 Apr:100:209-22. doi: 10.1016/j.critrevonc.2016.01.017. Epub 2016 Jan 22.

Authors

Dario Baratti¹, Shigeki Kusamura¹, Filippo Pietrantonio², Marcello Guaglio¹, Monica Niger², Marcello Deraco³

Affiliations

¹ Peritoneal Malignancy Program, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian, 1 20133 Milano, Italy.
² Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian, 1 20133 Milano, Italy.
³ Peritoneal Malignancy Program, Fondazione IRCCS Istituto Nazionale Tumori, via Venezian, 1 20133 Milano, Italy. Electronic address: marcello.deraco@istitutotumori.mi.it.

PMID: 26867984
DOI: 10.1016/j.critrevonc.2016.01.017

Abstract

Peritoneal metastases (PM) from colorectal cancer (CRC) were traditionally associated with bad prognosis. Only recently, cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has resulted in survival improvements. A systematic literature search between January 2010 and June 2015 was performed. Studies were selected and appraised according to predetermined criteria. Nineteen cohort studies, and thirteen comparative studies of CRS/HIPEC were included. The weighted median overall survival was 31.6 months (range 16-51). Major morbidity was 17.6-52.4% (weighted average 32.6%). Mortality was 0-8.1% (weighted average 2.9%). Additional relevant topics, such as CRC-PM prevalence, results by systemic therapies, preoperative work-up, and technical aspects were summarized through a narrative review. The recent literature suggests that CRS/HIPEC is gaining acceptance as standard of care for selected CRC-PM patients. Refinement of selection criteria, and rationalization of comprehensive systemic and local-regional management is ongoing. Prevention and early treatment of PM are new and promising options.

Keywords: Colorectal cancer; Cytoreductive surgery; HIPEC; Hyperthermic intraperitoneal chemotherapy; Liver metastasis; Peritoneal metastasis.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Antineoplastic Combined Chemotherapy Protocols / therapeutic use
Chemotherapy, Adjuvant
Cohort Studies
Colorectal Neoplasms / epidemiology
Colorectal Neoplasms / pathology*
Colorectal Neoplasms / therapy*
Combined Modality Therapy
Cytoreduction Surgical Procedures / methods
Humans
Hyperthermia, Induced
Infusions, Intralesional
Perioperative Care / methods
Peritoneal Neoplasms / epidemiology
Peritoneal Neoplasms / secondary*
Peritoneal Neoplasms / therapy*