Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: memo - Magazine of European Medical Oncology 4/2020

13.07.2020 | short review

Patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer

verfasst von: Philipp Horvath, Ingmar Königsrainer

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 4/2020

Einloggen, um Zugang zu erhalten
share
TEILEN

Summary

Background

Colorectal cancer is the most common origin of peritoneal metastasis in total, with 15% metastasizing to the peritoneum. In order to provide satisfactory peritoneal recurrence-free survival and low morbidity and mortality rates appropriate patient selection is crucial.

Methods

Literature research (Pubmed) from 2013 to 2020 was performed including the terms “colorectal”, “peritoneal”, “metastasis”, “cytoreductive surgery”, “HIPEC” and “patient selection”.

Results and conclusion

Despite predictive models the rate of non-therapeutic laparotomy is still high. Patients evaluated for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) should ideally undergo laparoscopy. CRS and HIPEC should be scheduled if a completeness of cytoreduction (CC)-0 score is achievable with a moderate peritoneal cancer index (PCI) (<15), ≤ three resectable liver metastases and, if applied, response to systemic chemotherapy. Signet ring histology can be seen as a relative contraindication. Presence of mutations (RAS/RAF), disease setting, primary tumor side, lymph node ratio and time point of systemic chemotherapy do not impact the treatment algorithm as yet.
Literatur
1.
Zurück zum Zitat Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2002;89:1545–50. CrossRef Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2002;89:1545–50. CrossRef
2.
Zurück zum Zitat Segelman J, Granath F, Holm T, Machado M, Mahteme H, Martling A. Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2012;99:699–705. CrossRef Segelman J, Granath F, Holm T, Machado M, Mahteme H, Martling A. Incidence, prevalence and risk factors for peritoneal carcinomatosis from colorectal cancer. Br J Surg. 2012;99:699–705. CrossRef
3.
Zurück zum Zitat Quere P, Facy O, Manfredi S, Jooste V, Faivre J, Lepage C, et al. Epidemiology, management and survival of peritoneal carcinomatosis from colorectal cancer: a population-based study. Dis Colon Rectum. 2015;58:743–52. CrossRef Quere P, Facy O, Manfredi S, Jooste V, Faivre J, Lepage C, et al. Epidemiology, management and survival of peritoneal carcinomatosis from colorectal cancer: a population-based study. Dis Colon Rectum. 2015;58:743–52. CrossRef
4.
Zurück zum Zitat Franko J, Shi Q, Meyers JP, Maughan TS, Adams RA, Seymour MT et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database. Lancet Oncol. 2016;17(12):1709–19. CrossRef Franko J, Shi Q, Meyers JP, Maughan TS, Adams RA, Seymour MT et al. Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the Analysis and Research in Cancers of the Digestive System (ARCAD) database. Lancet Oncol. 2016;17(12):1709–19. CrossRef
5.
Zurück zum Zitat Hall B, Padussis J, Foster JM. Cytoreduction and hyperthermic Intraperitoneal chemotherapy in the management of colorectal peritoneal metastasis. Surg Clin North Am. 2017;97(3):671–82. CrossRef Hall B, Padussis J, Foster JM. Cytoreduction and hyperthermic Intraperitoneal chemotherapy in the management of colorectal peritoneal metastasis. Surg Clin North Am. 2017;97(3):671–82. CrossRef
6.
Zurück zum Zitat Yong ZZ, Tan GHC, Shannon N, Chia C, Teo MCC. P.R.O.P.S.—A novel pre-operative predictive score for unresectability in patients with colorectal peritoneal metastases being considered for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). World J Surg Oncol. 2019;17(1):138. CrossRef Yong ZZ, Tan GHC, Shannon N, Chia C, Teo MCC. P.R.O.P.S.—A novel pre-operative predictive score for unresectability in patients with colorectal peritoneal metastases being considered for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). World J Surg Oncol. 2019;17(1):138. CrossRef
7.
Zurück zum Zitat Foster JM, Sleightholm R, Smith L, Ceelen W, Deraco M, Yildirim Y, et al. The American Society of Peritoneal Surface Malignancies Multi-Institution evaluation of 1,051 advanced ovarian cancer patients undergoing cytoreductive surgery and HIPEC: an introduction of the peritoneal surface disease severity score. J Surg Oncol. 2016;114(7):779–84. CrossRef Foster JM, Sleightholm R, Smith L, Ceelen W, Deraco M, Yildirim Y, et al. The American Society of Peritoneal Surface Malignancies Multi-Institution evaluation of 1,051 advanced ovarian cancer patients undergoing cytoreductive surgery and HIPEC: an introduction of the peritoneal surface disease severity score. J Surg Oncol. 2016;114(7):779–84. CrossRef
8.
Zurück zum Zitat Verwaal VJ, van Tinteren H, van Ruth S, Zoetmulder FA. Predicting the survival of patients with peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intraperitoneal chemotherapy. Br J Surg. 2004;91(6):739–46. CrossRef Verwaal VJ, van Tinteren H, van Ruth S, Zoetmulder FA. Predicting the survival of patients with peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intraperitoneal chemotherapy. Br J Surg. 2004;91(6):739–46. CrossRef
9.
Zurück zum Zitat Simkens GA, van Oudheusden TR, Nieboer D, Steyerberg EW, Rutten HJ, Luyer MD, et al. Development of a prognostic nomogram for patients with peritoneally metastasized colorectal cancer treated with cytoreductive surgery and HIPEC. Ann Surg Oncol. 2016;23(13):4214–21. CrossRef Simkens GA, van Oudheusden TR, Nieboer D, Steyerberg EW, Rutten HJ, Luyer MD, et al. Development of a prognostic nomogram for patients with peritoneally metastasized colorectal cancer treated with cytoreductive surgery and HIPEC. Ann Surg Oncol. 2016;23(13):4214–21. CrossRef
10.
Zurück zum Zitat Blackshaw GR, Barry JD, Edwards P, Allison MC, Thomas GV, Lewis WG. Laparoscopy significantly improves the perceived preoperative stage of gastric cancer. Gastric Cancer. 2003;6:225–9. CrossRef Blackshaw GR, Barry JD, Edwards P, Allison MC, Thomas GV, Lewis WG. Laparoscopy significantly improves the perceived preoperative stage of gastric cancer. Gastric Cancer. 2003;6:225–9. CrossRef
11.
Zurück zum Zitat Cashin PH, Graf W, Nygren P, Mahteme H. Patient selection for cytoreductive surgery in colorectal peritoneal carcinomatosis using serum tumor markers: an observational cohort study. Ann Surg. 2012;256(6):1078–83. CrossRef Cashin PH, Graf W, Nygren P, Mahteme H. Patient selection for cytoreductive surgery in colorectal peritoneal carcinomatosis using serum tumor markers: an observational cohort study. Ann Surg. 2012;256(6):1078–83. CrossRef
12.
Zurück zum Zitat Hallam S, Tyler R, Price M, Beggs A, Youssef H. Meta-analysis of prognostic factors for patients with colorectal peritoneal metastasis undergoing cytoreductive surgery and heated intraperitoneal chemotherapy. Br J Surg. 2019;3(5):585–94. Hallam S, Tyler R, Price M, Beggs A, Youssef H. Meta-analysis of prognostic factors for patients with colorectal peritoneal metastasis undergoing cytoreductive surgery and heated intraperitoneal chemotherapy. Br J Surg. 2019;3(5):585–94.
13.
Zurück zum Zitat van Oudheusden TR, Braam HJ, Nienhuijs SW, Wiezer MJ, van Ramshorst B, Luyer P, et al. Poor outcome after cytoreductive surgery and HIPEC for colorectal peritoneal carcinomatosis with signet ring cell histology. J Surg Oncol. 2015;111(2):237–42. CrossRef van Oudheusden TR, Braam HJ, Nienhuijs SW, Wiezer MJ, van Ramshorst B, Luyer P, et al. Poor outcome after cytoreductive surgery and HIPEC for colorectal peritoneal carcinomatosis with signet ring cell histology. J Surg Oncol. 2015;111(2):237–42. CrossRef
14.
Zurück zum Zitat Solomon D, DeNicola N, Feingold D, Liu PH, Aycart S, Golas BJ, et al. Signet ring cell features with peritoneal carcinomatosis in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are associated with poor overall survival. J Surg Oncol. 2019;119(6):758–65. CrossRef Solomon D, DeNicola N, Feingold D, Liu PH, Aycart S, Golas BJ, et al. Signet ring cell features with peritoneal carcinomatosis in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are associated with poor overall survival. J Surg Oncol. 2019;119(6):758–65. CrossRef
15.
Zurück zum Zitat Kwakman R, Schrama AM, van Olmen JP, Otten RH, de Lange-de Klerk ES, de Cuba EM, et al. Clinicopathological parameters in patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer metastases: a meta-analysis. Ann Surg. 2016;263(6):1102–11. CrossRef Kwakman R, Schrama AM, van Olmen JP, Otten RH, de Lange-de Klerk ES, de Cuba EM, et al. Clinicopathological parameters in patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer metastases: a meta-analysis. Ann Surg. 2016;263(6):1102–11. CrossRef
16.
Zurück zum Zitat Schneider MA, Eden J, Pache B, Laminger F, Lopez-Lopez V, Steffen T, et al. Mutations of RAS/RAF proto-oncogenes impair survival after cytoreductive surgery and HIPEC for peritoneal metastasis of colorectal origin. Ann Surg. 2018;268(5):845–53. CrossRef Schneider MA, Eden J, Pache B, Laminger F, Lopez-Lopez V, Steffen T, et al. Mutations of RAS/RAF proto-oncogenes impair survival after cytoreductive surgery and HIPEC for peritoneal metastasis of colorectal origin. Ann Surg. 2018;268(5):845–53. CrossRef
17.
Zurück zum Zitat Arjona-Sanchez A, Rodriguez-Ortiz L, Baratti D, Schneider MA, Gutiérrez-Calvo A, García-Fadrique A, et al. RAS mutation decreases overall survival after optimal cytoreductive surgery and hyperthermic intraperitoneal chemotherapy of colorectal peritoneal metastasis: a modification proposal of the peritoneal surface disease severity score. Ann Surg Oncol. 2019;26(8):2595–604. CrossRef Arjona-Sanchez A, Rodriguez-Ortiz L, Baratti D, Schneider MA, Gutiérrez-Calvo A, García-Fadrique A, et al. RAS mutation decreases overall survival after optimal cytoreductive surgery and hyperthermic intraperitoneal chemotherapy of colorectal peritoneal metastasis: a modification proposal of the peritoneal surface disease severity score. Ann Surg Oncol. 2019;26(8):2595–604. CrossRef
18.
Zurück zum Zitat Morgan Z, Chow BE, Strong EA, Tsai S, Christians K, Mogal H, et al. RAS mutation status confers prognostic relevance in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer. J Surg Res. 2019;240:130–5. CrossRef Morgan Z, Chow BE, Strong EA, Tsai S, Christians K, Mogal H, et al. RAS mutation status confers prognostic relevance in patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer. J Surg Res. 2019;240:130–5. CrossRef
19.
Zurück zum Zitat Kelly KJ, Alsayadnasser M, Vaida F, Veerapong J, Baumgartner JM, Patel S, et al. Does primary tumor side matter in patients with metastatic colon cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy? Ann Surg Oncol. 2019;26(5):1421–7. CrossRef Kelly KJ, Alsayadnasser M, Vaida F, Veerapong J, Baumgartner JM, Patel S, et al. Does primary tumor side matter in patients with metastatic colon cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy? Ann Surg Oncol. 2019;26(5):1421–7. CrossRef
20.
Zurück zum Zitat Hentzen JEKR, Rovers KP, Kuipers H, van der Plas WY, Been LB, Hoogwater FJH, et al. Impact of synchronous versus metachronous onset of colorectal peritoneal metastases on survival outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a multicenter, retrospective, observational study. Ann Surg Oncol. 2019;26(7):2210–21. CrossRef Hentzen JEKR, Rovers KP, Kuipers H, van der Plas WY, Been LB, Hoogwater FJH, et al. Impact of synchronous versus metachronous onset of colorectal peritoneal metastases on survival outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC): a multicenter, retrospective, observational study. Ann Surg Oncol. 2019;26(7):2210–21. CrossRef
21.
Zurück zum Zitat Iversen LH, Rasmussen PC, Laurberg S. Value of laparoscopy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis. Br J Surg. 2013;100(2):285–92. CrossRef Iversen LH, Rasmussen PC, Laurberg S. Value of laparoscopy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis. Br J Surg. 2013;100(2):285–92. CrossRef
22.
Zurück zum Zitat Hentzen JEKR, van der Plas WY, Constansia RDN, Been LB, Hoogwater FJH, van Ginkel RJ, et al. Role of diagnostic laparoscopy in patients with suspicion of colorectal peritoneal metastases to evaluate suitability for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Br J Surg. 2019;3(6):812–21. Hentzen JEKR, van der Plas WY, Constansia RDN, Been LB, Hoogwater FJH, van Ginkel RJ, et al. Role of diagnostic laparoscopy in patients with suspicion of colorectal peritoneal metastases to evaluate suitability for cytoreductive surgery with hyperthermic intraperitoneal chemotherapy. Br J Surg. 2019;3(6):812–21.
Metadaten
Titel
Patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer
verfasst von
Philipp Horvath
Ingmar Königsrainer
Publikationsdatum
13.07.2020
Verlag
Springer Vienna
Erschienen in
memo - Magazine of European Medical Oncology / Ausgabe 4/2020
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-020-00633-w