Peritoneal carcinomatosis of colorectal origin： Incidence, prognosis and treatment options

• Published in: World journal of gastroenterology : WJG Vol. 18; no. 39; pp. 5489 - 5494
• Main Authors: Klaver, Yvonne L B, Lemmens, Valery E P P, Nienhuijs, Simon W, Luyer, Misha D P, de Hingh, Ignace H J T
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Co., Limited 21-10-2012
• Subjects: Carcinoma - diagnosis; Carcinoma - epidemiology; Carcinoma - secondary; Carcinoma - therapy; Colorectal Neoplasms - pathology; Humans; Incidence; Peritoneal Neoplasms - diagnosis; Peritoneal Neoplasms - epidemiology; Peritoneal Neoplasms - secondary; Peritoneal Neoplasms - therapy; Prognosis; 发病率; 大肠癌; 手术治疗; 治疗方案; 热化疗; 腹膜; 起源; 预后; Hyperthermic intraperitoneal chemotherapy; Chemotherapy; Prognosis; Colorectal cancer; Peritoneal carcinomatosis
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i39.5489

Peritoneal carcinomatosis （PC） is one manifestation of metastatic colorectal cancer （CRC）. Tumor growth on intestinal surfaces and associated fluid accumulation eventually result in bowel obstruction and incapacitat- ing levels of ascites, which profoundly affect the qual- ity of life for affected patients. PC appears resistant to traditional 5-fluorouracil-based chemotherapy, and surgery was formerly reserved for palliative purposes only. In the absence of effective treatment, the histori- cal prognosis for these patients was extremely poor, with an invariably fatal outcome. These poor outcomes likely explain why PC secondary to CRC has received little attention from oncologic researchers. Thus, data are lacking regarding incidence, clinical disease course, and accurate treatment evaluation for patients with PC. Recently, population-based studies have revealed that PC occurs relatively frequently among patients with CRC. Risk factors for developing PC have been identi- fied： right-sided tumor, advanced T-stage, advanced N-stage, poor differentiation grade, and younger age at diagnosis. During the past decade, both chemother- apeutical and surgical treatments have achieved prom- ising results in these patients. A chance for long-term survival or even cure may now be offered to selected patients by combining radical surgical resection with intraperitoneal instillation of heated chemotherapy. This combined procedure has become known as hy- perthermic intraperitoneal chemotherapy. This edito- rial outlines recent advancements in the medical and surgical treatment of PC and reviews the most recent information on incidence and prognosis of this disease. Given recent progress, treatment should now be con- sidered in every patient presenting with PC.