ASO Author Reflections: Challenges of Circulating Tumor DNA in the Management of Gastrointestinal Peritoneal Carcinomatosis

Sullivan, Brittany; Dayyani, Farshid; Senthil, Maheswari

doi:10.1245/s10434-022-12543-8

Cited by 1 publication

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References 10 publications

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“…Challenges include low detection rates and tissue-plasma discordance in PM compared to extraperitoneal metastases. This may be due to a plasmaperitoneal barrier limiting tumor DNA shedding, contrasting with visceral metastatic sites which are well vascularized [90][91][92]. However, small retrospective series suggest higher diagnostic accuracy for postoperative relapse with ctDNA compared to standard markers [93,94].…”

Section: Block 10: Recurrence After Crsmentioning

confidence: 99%

Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases

Turaga

2024

Preprint

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Background The peritoneum is a common site of metastases from colorectal cancer (CRC), yet controversy exists regarding optimal treatment strategies. These guidelines describe the results of a national consensus addressing the management of CRC with peritoneal metastases (CRC-PM). Methods An update of the 2018 Chicago Consensus Guidelines was conducted using a modified Delphi technique. Two rounds of voting were performed to assess agreement levels on two clinical management pathways regarding synchronous and metachronous CRC-PM. Supporting evidence was evaluated via rapid literature reviews. Results The overall level of evidence was low in existing literature. Of 145 participants in the first round, 136 (96.8%) responded in the second round. Over 90% consensus was achieved in most pathway blocks. For both pathways, early referral to a peritoneal surface malignancy (PSM) center should be made for patients with CRC-PM. For the synchronous pathway, upfront cytoreductive surgery was de-emphasized in favor of systemic therapy. For the metachronous pathway, risk stratification via clinical and pathologic features was revised. For both pathways, surveillance strategies were added, including only a weak recommendation for circulating tumor DNA (ctDNA) testing given limited evidence of its utility in detecting and monitoring PM. Conclusion The consensus-driven clinical pathways provide valuable guidance for the management of CRC-PM. There remains a need for high-quality evidence and prospective multicenter trials in this domain.

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Section: Block 10: Recurrence After Crsmentioning

confidence: 99%

Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases

Turaga

2024

Preprint

View full text Add to dashboard Cite

show abstract

ASO Author Reflections: Challenges of Circulating Tumor DNA in the Management of Gastrointestinal Peritoneal Carcinomatosis

Cited by 1 publication

References 10 publications

Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases

Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases

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