Peritoneal Carcinomatosis in Colorectal Cancers – Management Perspective Needs a Change
| Autor: | Manish Bhandare, Prachi Patil, Vishwas Pai, Rahul Bhamre, Reena Engineer, Vikas Ostwal, Avanish Saklani |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Organoplatinum Compounds Colorectal cancer Leucovorin 030230 surgery Metastasis Capecitabine 03 medical and health sciences Folinic acid 0302 clinical medicine FOLFOX Antineoplastic Combined Chemotherapy Protocols medicine Humans Peritoneal Neoplasms Retrospective Studies business.industry Incidence Gastroenterology Cytoreduction Surgical Procedures Hyperthermia Induced Middle Aged medicine.disease Combined Modality Therapy digestive system diseases Surgery Oxaliplatin Survival Rate Oncology Fluorouracil 030220 oncology & carcinogenesis Female Hyperthermic intraperitoneal chemotherapy Colorectal Neoplasms business Follow-Up Studies medicine.drug |
| Zdroj: | Clinical Colorectal Cancer. 16:e1-e6 |
| ISSN: | 1533-0028 |
| Popis: | Peritoneal carcinomatosis (PC) from colorectal cancers (CRC) either at initial presentation or at subsequent recurrence presents a significant treatment challenge. The aim of our study was to find its incidence and analyze outcomes of patients with PC from CRC origin managed by different treatment modalities.A retrospective analysis of patients, from August 2013 to July 2014, presenting with metastatic peritoneal disease from CRC with or without metastasis to other sites was performed. PC was classified as limited (peritoneal carcinomatosis index [PCI] 10) and widespread (PCI10).This study included 70 patients; 45 patients had peritoneum as the only site of metastasis and the remaining 25 visceral metastasis with peritoneum. Resections were performed in 23 patients (19 underwent R0 resection and 4 were R+). All patients received systemic chemotherapy (FOLFOX [Oxaliplatin with fluorouracil and folinic acid]/CAPOX [oxaliplatin and capecitabine]). At a median follow-up of 11 months, the median OS was 14 months. Patients with PCI 10 had significantly better survival (median not reached) as compared with those with PCI10 (15 months). Patients undergoing R0 resection had better survival (24 months) versus those with R+ resection (16 months). The survival of patients receiving only systemic chemotherapy was 11 months.The incidence of peritoneal metastasis in CRC is about 10%. A select group of patients who have low PCI who undergo R0 resection of only the diseased portion, without entire peritonectomy, still do well. Where facilities for hyperthermic intraperitoneal chemotherapy are not available, cytoreduction followed by systemic chemotherapy should be considered. The added role of hyperthermic intraperitoneal chemotherapy in this subgroup needs to be evaluated. |
| Databáze: | OpenAIRE |
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