Peritoneal carcinomatosis is a form of intra-abdominal spread of cancer of gastrointestinal, gynecological, or peritoneum origin and is diagnosed by the presence of tumor nodules on the peritoneal surface. It is an advanced stage of primary tumors of the peritoneum such as peritoneal mesothelioma or peritoneal pseudomyxoma, or secondary in cases of ovarian or digestive cancer.
Until recently, peritoneal carcinomatosis was considered a terminal stage of the disease. However, the development of new surgical and chemotherapy techniques has changed the prognosis of this disease, achieving very satisfactory survival rates.
A new study in which Dr. François Quenet, from Quénet Torrent Institute has participated, has shown that between 15% and 18% of patients with peritoneal carcinomatosis of colorectal origin are cured thanks to the combination of systemic chemotherapy and surgery of complete resection of the lesions present in the peritoneum.
Cytoreductive surgery is based on the removal of all macroscopically visible tumor implants found in the abdomen. It is a highly complex surgery that must be performed by a specialized surgeon with experience in this type of intervention.
Another of the most important results of this study points out that complete resection of peritoneal lesions is the most important prognostic factor and allows unexpectedly high survival rates.
Moreover, the study has shown the importance for patients with peritoneal carcinomatosis of colorectal origin being referred to a specialized center with experts and specialized surgeons, since this is where they will be able to perform a complete resection and consequently, the patient will have much better survival rates than those obtained with chemotherapy only or in a non-specialized cancer center.
Thus, the study data suggest that debulking surgery itself should be the cornerstone of therapeutic strategies with curative intent for colorectal peritoneal metastases, although it is also indicated that on some occasions the indication of HIPEC must be individualized for patients with peritoneal carcinomatosis of colorectal origin.
If you want to know more about these surgical techniques or about the treatment of peritoneal carcinomatosis, do not hesitate to contact our team of specialists.
References:
- The Lancet Oncology. “Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicenter, randomized, open-label, phase 3 trial. Available online: https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30599-4/fulltext