Peritoneal carcinomatosis of colorectal origin:Incidence,prognosis and treatment options

作     者：Yvonne LB Klaver Valery EPP Lemmens Simon W Nienhuijs Misha DP Luyer Ignace HJT de Hingh 

作者机构：Department of Surgical OncologyCatharina Hospital EindhovenMichelangelolaan 25623 EJ EindhovenThe Netherlands Department of Public HealthErasmus Medical Centre RotterdamDr Molewaterplein 503015 CE RotterdamThe Netherlands 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第39期

页      面：5489-5494页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Colorectal cancer Peritoneal carcinomato-sis Hyperthermic intraperitoneal chemotherapy Che-motherapy Prognosis 

摘      要：Peritoneal carcinomatosis (PC) is one manifestation of metastatic colorectal cancer (CRC). Tumor growth on intestinal surfaces and associated fluid accumulation eventually result in bowel obstruction and incapacitating levels of ascites, which profoundly affect the quality of life for affected patients. PC appears resistant to traditional 5-fluorouracil-based chemotherapy, and surgery was formerly reserved for palliative purposes only. In the absence of effective treatment, the histori-cal prognosis for these patients was extremely poor, with an invariably fatal outcome. These poor outcomes likely explain why PC secondary to CRC has received little attention from oncologic researchers. Thus, data are lacking regarding incidence, clinical disease course, and accurate treatment evaluation for patients with PC. Recently, population-based studies have revealed that PC occurs relatively frequently among patients withCRC. Risk factors for developing PC have been identi-fied:right-sided tumor, advanced T-stage, advanced N-stage, poor differentiation grade, and younger age at diagnosis. During the past decade, both chemother-apeutical and surgical treatments have achieved prom-ising results in these patients. A chance for long-term survival or even cure may now be offered to selected patients by combining radical surgical resection with intraperitoneal instillation of heated chemotherapy. This combined procedure has become known as hy-perthermic intraperitoneal chemotherapy. This edito-rial outlines recent advancements in the medical and surgical treatment of PC and reviews the most recent information on incidence and prognosis of this disease. Given recent progress, treatment should now be considered in every patient presenting with PC.