Incidence and prognosis of synchronous colorectal carcinomatosis: evolution since 1985?

Evaluation of: Lemmens VE, Klaver YL, Verwaal VJ, Rutten HJ, Coebergh JW, de Hingh IH. Predictors and survival of synchronous peritoneal carcinomatosis of colorectal origin: a population-based study. Int. J. Cancer 128, 2717-2725 (2011). Until recently, colorectal peritoneal carcinomatosis was considered inaccessible to curative therapy, hence the paucity of epidemiological and clinical features available to date regarding the disease. In this retrospective study, spanning 1995-2008, approximately 5% of the patients with colorectal cancer, recorded in the cancer registry of southern Netherlands, had synchronous carcinomatosis, confined to the peritoneum in nearly half of them. Despite progress in chemotherapy, surgery and anesthesiology, the survival of patients with synchronous carcinomatosis has not increased (median survival of 8 months), unlike that of patients with liver metastases. Although, only 11% of the patients had undergone complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy during the latest period (2006-2008). In the future, all patients with isolated colorectal carcinomatosis should be evaluated for curative therapy with complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.