Second-look surgery plus hyperthermic intraperitoneal chemotherapy for patients with colorectal cancer at high risk of peritoneal carcinomatosis: Does it really save lives?
The treatment of peritoneal carcinomatosis (PC) of colorectal origin with cytoreductive surgery(CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has a 5-year recurrence-free or cure rate of at least 16%, so it is no longer labeled as a fatal disease, and offers prolonged survival for pati...
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Published in | World journal of gastroenterology : WJG Vol. 23; no. 3; pp. 377 - 381 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
United States
Baishideng Publishing Group Inc
21.01.2017
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Subjects | |
Online Access | Get full text |
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Summary: | The treatment of peritoneal carcinomatosis (PC) of colorectal origin with cytoreductive surgery(CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has a 5-year recurrence-free or cure rate of at least 16%, so it is no longer labeled as a fatal disease, and offers prolonged survival for patients with a low peritoneal carcinomatosis index. Metachronous PC of colorectal origin is so predictable that there is a model which has been used to successfully determine the individual risk of each patient. Patients at risk are clearly identified; those with the highest risk have small peritoneal nodules present in the first surgery (70% probability of developing PC), ovarian metastases(60%), perforated tumor onset or intraoperative tumor rupture(50%). Current clinical, biological and imaging techniques still lack sufficient sensitivity to diagnose PC in its initial stages, when CRS plus HIPEC has a greater impact and a higher cure rate. Second-look surgery with HIPEC or prophylactic HIPEC at the time of the first intervention have been proposed as means of preventing and/or anticipating clinical or radiological relapse in at-risk patients. Both techniques have shown a significant decrease in peritoneal relapses and should be considered essential weapons in the management of colorectal cancer. |
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Bibliography: | SourceType-Other Sources-1 content type line 63 ObjectType-Editorial-2 ObjectType-Commentary-1 Telephone: +34-651-924994 Author contributions: Cortes-Guiral D wrote this paper; Elias D, Cascales-Campos PA, Badía Yébenes A, Guijo Castellano I, León Carbonero AI, Martín Valadés JI, Garcia-Foncillas J and Garcia-Olmo D reviewed this article. Correspondence to: Delia Cortes-Guiral, MD, Department of General Surgery (Peritoneal Surface Surgical Oncology), Fundación Jiménez Díaz Hospital, Avda. Reyes Católicos 2, 28050 Madrid, Spain. delia.cortes.guiral@gmail.com |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v23.i3.377 |