Progress in treatments for colorectal cancer peritoneal metastases during the years 2010-2015. A systematic review
A partir d'une revue systématique de la littérature publiée entre janvier 2010 et juin 2015 (32 études), cette étude analyse les progrès réalisés dans le traitement des métastases péritonéales ayant pour origine un cancer colorectal
Peritoneal metastases (PM) from colorectal cancer (CRC) were traditionally associated with bad prognosis. Only recently, cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has resulted in survival improvements. A systematic literature search between January 2010 and June 2015 was performed. Studies were selected and appraised according to predetermined criteria. Nineteen cohort studies, and thirteen comparative studies of CRS/HIPEC were included. The weighted median overall survival was 31.6 months (range 16–51). Major morbidity was 17.6–52.4% (weighted average 32.6%). Mortality was 0-8.1% (weighted average 2.9%). Additional relevant topics, such as CRC-PM prevalence, results by systemic therapies, preoperative work-up, and technical aspects were summarized through a narrative review. The recent literature suggests that CRS/HIPEC is gaining acceptance as standard of care for selected CRC-PM patients. Refinement of selection criteria, and rationalization of comprehensive systemic and local-regional management is ongoing. Prevention and early treatment of PM are new and promising options.
http://www.sciencedirect.com/science/article/pii/S1040842816300178 2016