Treatment and prognosis of colorectal cancer with synchronous peritoneal metastasis. Credit: Xiusen Qin, Zifeng Yang, Yang Li, Jian Luo, Hui Wang, Huaiming Wang
Colorectal cancer (CRC) with synchronous peritoneal metastases (SPM) is a difficult disease to treat and has a relatively poor prognosis. However, recent advances in treatment strategies have improved outcomes for patients with SPM.
The optimal treatment approach for CRC using SPM remains controversial. Increasing evidence suggests that comprehensive treatment including cytoreductive surgery (CRS), chemotherapy, and hyperthermic intraperitoneal chemotherapy (HIPEC) may improve patient outcomes.
Recent research in China published in journals electronic gastroenterologyevaluated treatment strategies and clinical outcomes in colorectal cancer patients with SPM. This study included a large patient sample, and the results suggest that comprehensive treatment is associated with significantly improved prognosis.
Specifically, median overall survival for patients who received CRS, chemotherapy, and HIPEC was 29 months, compared to 14 months for patients who received less aggressive treatment. The study also found that complete cytoreductive surgery (CC-0), which removes all visible cancer during CRS, was an independent predictor of improved survival.
The results of this study are important as they provide further evidence supporting the use of comprehensive treatment for colorectal cancer patients with SPM. This study also highlights the importance of her CC-0 in achieving long-term survival benefits.
However, it is important to note that this study is observational and cannot establish a causal relationship between treatment and outcome. More sophisticated stratification and randomized clinical trials are needed to address potential confounders and biases.
The study also pointed out that current knowledge on the treatment and prognosis of colorectal cancer with SPM is inconclusive and studies with large samples from China are still lacking.
This is supported by the fact that most studies on the treatment and prognosis of patients with colorectal SPM have been conducted in Europe and North America, with limited data available from China. Furthermore, the optimal treatment approach for CRC using SPM remains controversial.
The researchers also highlighted that National Comprehensive Cancer Network (NCCN) guidelines are conservative regarding CRS and HIPEC, and clinicians still tend to favor palliative care for patients with CRC with peritoneal metastases.
Overall, the results of this study suggest that CRC patients with SPM who received integrated treatment have a favorable prognosis. In particular, CC-0 should be considered to achieve long-term survival benefits. However, further research is needed to refine treatment strategies and identify the optimal therapeutic approach for all CRC patients with SPM.
For more information:
Xiusen Qin et al., Treatment and prognosis of colorectal cancer with synchronous peritoneal metastasis: an 11-year single-center experience; electronic gastroenterology (2023). DOI: 10.1136/egastro-2023-100016
Provided by Jilin University First Hospital
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