Recommendations for the optimal management of peritoneal metastases in patients with colorectal cancer: a TTD and GECOP-SEOQ expert consensus statement

• Cristina Grávalos ^[1] ; Fernando Pereira ^[2] ; Ruth Vera ^[3] ; Alvaro Arjona-Sánchez ^[4] ; Ferran Losa ^[7] ; Isabel Ramos ^[8] ; Pilar García-Alfonso ^[5] ; Luis Gonzalez-Bayón ^[5] ; Pedro Antonio Cascales-Campos ^[6] ; Enrique Aranda ^[9]
  1. [1] Hospital Universitario 12 de Octubre

     Hospital Universitario 12 de Octubre

     Madrid, España

     
  2. [2] Hospital de Fuenlabrada

     Hospital de Fuenlabrada

     Fuenlabrada, España

     
  3. [3] Hospital Universitario de Navarra

     Hospital Universitario de Navarra

     Pamplona, España

     
  4. [4] Hospital Universitario Reina Sofia

     Hospital Universitario Reina Sofia

     Cordoba, España

     
  5. [5] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  6. [6] Hospital Virgen de la Arrixaca

     Hospital Virgen de la Arrixaca

     Murcia, España

     
  7. [7] Servicio de Oncología Médica, Sant Joan Despí - Hospital Moisés Broggi/ICO-Hospitalet, Barcelona, España
  8. [8] Servicio de Cirugía, Sant Joan Despí - Hospital Moisés Broggi, Hospitalet de Llobregat, España
  9. [9] Servicio de Oncología Médica, Hospital Universitario Reina Sofía, Instituto de Investigaciones Biomédicas Maimónides de Córdoba (IMIBIC), Universidad de Córdoba, Centro de Investigación Biomédica en Red del Cáncer (CIBERONC), Instituto de Salud Carlos III, Córdoba, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 25, Nº. 12 (December), 2023, págs. 3378-3394
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Peritoneal metastases (PM) occur when cancer cells spread inside the abdominal cavity and entail an advanced stage of colorectal cancer (CRC). Prognosis, which is poor, correlates highly with tumour burden, as measured by the peritoneal cancer index (PCI). Cytoreductive surgery (CRS) in specialized centres should be offered especially to patients with a low to moderate PCI when complete resection is expected. The presence of resectable metastatic disease in other organs is not a contraindication in well-selected patients. Although several retrospective and small prospective studies have suggested a survival benefit of adding hyperthermic intraperitoneal chemotherapy (HIPEC) to CRS, the recently published phase III studies PRODIGE-7 in CRC patients with PM, and COLOPEC and PROPHYLOCHIP in resected CRC with high-risk of PM, failed to show any survival advantage of this strategy using oxaliplatin in a 30-min perfusion. Final results from ongoing randomized phase III trials testing CRS plus HIPEC based on mitomycin C (MMC) are awaited with interest. In this article, a group of experts selected by the Spanish Group for the Treatment of Digestive Tumours (TTD) and the Spanish Group of Peritoneal Oncologic Surgery (GECOP), which is part of the Spanish Society of Surgical Oncology (SEOQ), reviewed the role of HIPEC plus CRS in CRC patients with PM. As a result, a series of recommendations to optimize the management of these patients is proposed.