Recommendations for the optimal management of peritoneal metastases in patients with colorectal cancer: a TTD and GECOP-SEOQ expert consensus statement

Grávalos, Cristina; Pereira, Fernando; Vera, Ruth; Arjona‐Sánchez, Álvaro; Losa, F.; Ramos, Isabel; García‐Alfonso, Pilar; González-Bayón, L.; Campos, Pedro Antonio Cascales; Aranda, Enrique

doi:10.1007/s12094-023-03204-7

Cited by 1 publication

(4 citation statements)

References 96 publications

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“…Therefore, it is controversial whether to include peritoneal metastases of CRC in oligometastases. On the other hand, cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) has been performed and may be curative in selected patients when carried out at experienced high-volume centers; the 5-year OS can reach 30–50% in patients with limited peritoneal metastases achieving complete resection [ 110 , 111 , 112 , 113 , 114 , 115 , 116 ].…”

Section: Local Treatmentsmentioning

confidence: 99%

“…CC-0 indicates no visible residual peritoneal lesions, while CC-1, CC-2, and CC-3 indicate residual tumor < 2.5 mm, 2.5 mm–2.5 cm, and >2.5 cm, respectively [ 117 ]. CC-0 provides the best postoperative prognosis, and CC-1 might be effective when combined with HIPEC, while CC-2 and CC-3, considered incomplete, have a negative influence on survival [ 112 , 113 , 114 , 118 , 119 ].…”

Section: Local Treatmentsmentioning

confidence: 99%

“…Increasing PCI is associated with worse survival, and the best survival results are obtained with PCI ≤ 10, while PCI > 20 is considered as a relative contraindication to CRS due to poor prognosis. The prognosis of PCI 10–20 is different between studies, and these limits are not yet clearly established [ 112 , 113 , 114 , 116 , 120 , 121 , 122 ].…”

Section: Local Treatmentsmentioning

confidence: 99%

“…Although CRS plus HIPEC is considered as an acceptable option, routinely adding HIPEC to CRS is not recommended [ 23 ]. There are ongoing trials to investigate if other HIPEC regimens (using mitomycin and different HIPEC procedures) may possibly lead to better outcomes [ 112 , 125 ].…”

Section: Local Treatmentsmentioning

confidence: 99%

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Optimizing Treatment Strategy for Oligometastases/Oligo-Recurrence of Colorectal Cancer

Yokoi,

Tajima,

Fukada

et al. 2023

Cancers

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Colorectal cancer (CRC) is the third most common cancer, and nearly half of CRC patients experience metastases. Oligometastatic CRC represents a distinct clinical state characterized by limited metastatic involvement, demonstrating a less aggressive nature and potentially improved survival with multidisciplinary treatment. However, the varied clinical scenarios giving rise to oligometastases necessitate a precise definition, considering primary tumor status and oncological factors, to optimize treatment strategies. This review delineates the concepts of oligometastatic CRC, encompassing oligo-recurrence, where the primary tumor is under control, resulting in a more favorable prognosis. A comprehensive examination of multidisciplinary treatment with local treatments and systemic therapy is provided. The overarching objective in managing oligometastatic CRC is the complete eradication of metastases, offering prospects of a cure. Essential to this management approach are local treatments, with surgical resection serving as the standard of care. Percutaneous ablation and stereotactic body radiotherapy present less invasive alternatives for lesions unsuitable for surgery, demonstrating efficacy in select cases. Perioperative systemic therapy, aiming to control micrometastatic disease and enhance local treatment effectiveness, has shown improvements in progression-free survival through clinical trials. However, the extension of overall survival remains variable. The review emphasizes the need for further prospective trials to establish a cohesive definition and an optimized treatment strategy for oligometastatic CRC.

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