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Colorectal carcinomatosis: a new oncologic frontier
1Washington Cancer Institute, Washington Hospital Center, DC 20010, USA. Paul.sugarbaker@medstar.net
Current Opinion in Oncology
|June 4, 2005
Summary
Cytoreductive surgery combined with hyperthermic chemotherapy offers long-term survival for colorectal cancer carcinomatosis patients. This innovative treatment strategy is now recommended for broader patient application.
Area of Science:
- Oncology
- Surgical Oncology
- Gastrointestinal Oncology
Background:
- Colorectal cancer carcinomatosis was historically considered a terminal condition with limited survival.
- Effective treatment options for widespread carcinomatosis were previously lacking.
Purpose of the Study:
- To evaluate a novel treatment strategy for colorectal cancer carcinomatosis.
- To determine the long-term survival outcomes associated with cytoreductive surgery and hyperthermic chemotherapy.
Main Methods:
- The study involved cytoreductive surgery to remove visible cancerous implants.
- Intraoperative chemotherapy with moderate hyperthermia (41-43°C) was administered to eradicate microscopic disease.
- Data from multiple Phase II and Phase III trials, including a multi-institutional study of 503 patients, were analyzed.
Main Results:
- The combined approach of cytoreductive surgery and hyperthermic chemotherapy demonstrated significant long-term survival benefits.
- Approximately one-third of patients treated with this strategy achieved long-term survival.
- This represents a substantial improvement over historical survival rates for carcinomatosis.
Conclusions:
- The combination of cytoreductive surgery and hyperthermic chemotherapy is a viable and effective treatment for colorectal cancer carcinomatosis.
- Expansion of this treatment to a larger patient population is warranted.
- This strategy offers a new paradigm for managing advanced colorectal cancer with peritoneal spread.