Colorectal cancer peritoneal metastases: Biology, treatment and next steps

The presence of peritoneal metastases in patients with advanced colorectal cancer is associated with poor prognosis but the mechanisms for this are unclear. This review summarises the current knowledge of the pathophysiology, clinical features, prevalence, prognosis, and molecular biology of periton...

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Bibliographic Details
Published in:European journal of surgical oncology 2020-04, Vol.46 (4), p.675-683
Main Authors: Baaten, Ilona C.P.A., West, Nicholas P., Quyn, Aaron J., Seymour, Matthew T., Seligmann, Jenny F.
Format: Article
Language:English
Subjects:
Antineoplastic Agents - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biology
Carcinoma - genetics
Carcinoma - secondary
Carcinoma - therapy
Chemotherapy, Adjuvant
Colorectal cancer
Colorectal Neoplasms - genetics
Colorectal Neoplasms - pathology
Cytoreduction Surgical Procedures
Humans
Hyperthermia, Induced
Immunotherapy, Adoptive
Infusions, Parenteral
Intraperitoneal chemotherapy
Peritoneal metastases
Peritoneal Neoplasms - genetics
Peritoneal Neoplasms - secondary
Peritoneal Neoplasms - therapy
Prognosis
Proto-Oncogene Proteins B-raf - genetics
Proto-Oncogene Proteins p21(ras) - genetics
Risk Factors
Treatment
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Summary:The presence of peritoneal metastases in patients with advanced colorectal cancer is associated with poor prognosis but the mechanisms for this are unclear. This review summarises the current knowledge of the pathophysiology, clinical features, prevalence, prognosis, and molecular biology of peritoneal metastases and the risk factors for the development of peritoneal metastases following resection of a primary colorectal tumour. Furthermore, the evidence for treatment strategies are described including cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, early post-operative intraperitoneal chemotherapy, sequential post-operative intraperitoneal chemotherapy and emerging novel strategies. Active areas of research should include the identification of individuals at high risk of peritoneal metastases after curative resection of primary tumour, development of a surveillance program for high-risk patients, optimisation of systematic therapies and further investigation of the use of intraperitoneal chemotherapy.
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2019.10.035