Peritoneal Metastases: Prevention and Treatment

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Colorectal cancer (CRC) is often curable surgically, but advanced or metastatic stages necessitate multimodal treatment approaches.
• The emergence of molecular markers, such as RAS mutations, has significantly altered the management landscape for metastatic CRC.
• Peritoneal surface metastasis occurs in 15-20% of CRC cases, presenting complex therapeutic challenges.

Purpose of the Study:

• To highlight current management strategies for colorectal cancer with peritoneal metastasis.
• To discuss the ongoing debate regarding systemic therapy versus cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC).
• To emphasize the prevention and treatment of peritoneal metastasis in colorectal cancer.

Main Methods:

• Review of existing literature on colorectal cancer management, focusing on peritoneal metastasis.
• Analysis of treatment modalities including systemic therapy, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy (HIPEC).
• Discussion of clinical evidence and ongoing debates in the field.

Main Results:

• Colorectal cancer with peritoneal metastasis requires a tailored, multimodal treatment approach.
• Cytoreductive surgery combined with HIPEC is a key consideration for managing peritoneal metastasis.
• Molecular markers influence treatment decisions in metastatic colorectal cancer.

Conclusions:

• Effective management of colorectal cancer with peritoneal metastasis hinges on a comprehensive, multimodal strategy.
• The choice between systemic therapy and cytoreductive surgery with or without HIPEC remains a critical decision point.
• Further research and standardized protocols are essential for optimizing outcomes in these challenging cases.