Randomized clinical trials for colorectal cancer peritoneal surface malignancy

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Peritoneal carcinomatosis (CRCPC) affects over 40% of patients with colorectal cancer.
• Limited level I data exists from prospective randomized trials for CRCPC treatment.
• Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) shows promising survival rates in selected patients.

Purpose of the Study:

• To highlight the incidence and outcomes of CRCPC.
• To emphasize the need for early identification of peritoneal carcinomatosis.
• To advocate for further trials confirming the efficacy of multimodality therapy for CRCPC.

Main Methods:

• Literature review of patients with colorectal cancer and peritoneal carcinomatosis.
• Analysis of outcomes for patients treated with CRS plus HIPEC.
• Assessment of current evidence gaps regarding prospective randomized trials.

Main Results:

• Over 40% of colorectal cancer patients develop peritoneal carcinomatosis.
• Approximately 1000 patients underwent CRS plus HIPEC, with median survival ranging from 22 to 63 months.
• Prospective randomized trial data remains limited.

Conclusions:

• Multimodality therapy including CRS/HIPEC shows potential for CRCPC management.
• Early detection of peritoneal carcinomatosis is crucial for optimal patient outcomes.
• Further high-quality clinical trials are essential to validate and refine treatment strategies for CRCPC in the era of novel systemic therapies.