Summary of current therapeutic options for peritoneal metastases from colorectal cancer

Terence C. Chua, Jesus Esquivel, Joerg O W Pelz, David L. Morris

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)566-573
Number of pages8
JournalJournal of Surgical Oncology
Volume107
Issue number6
DOIs
StatePublished - May 2013

Fingerprint

Colorectal Neoplasms
Neoplasm Metastasis
Drug Therapy
Survival
Palliative Care
Therapeutics
Peritoneum
Standard of Care
PubMed
Randomized Controlled Trials
Databases

Keywords

  • Bevacizumab
  • Cetuximab
  • colorectal cancer
  • fluorouracil
  • Irinotecan
  • metastasis
  • Oxaliplatin
  • peritoneal carcinomatosis
  • systemic chemotherapy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Summary of current therapeutic options for peritoneal metastases from colorectal cancer. / Chua, Terence C.; Esquivel, Jesus; Pelz, Joerg O W; Morris, David L.

In: Journal of Surgical Oncology, Vol. 107, No. 6, 05.2013, p. 566-573.

Research output: Contribution to journalArticle

Chua, Terence C. ; Esquivel, Jesus ; Pelz, Joerg O W ; Morris, David L. / Summary of current therapeutic options for peritoneal metastases from colorectal cancer. In: Journal of Surgical Oncology. 2013 ; Vol. 107, No. 6. pp. 566-573.
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AB - 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.

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