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Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a viable option for selected patients with peritoneal metastases (PM) from colorectal origin, resulting in long-term survival and even cure in some cases. However, adequate patient selection for this treatment is cu...

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Autores principales: Simkens, Geert A, Rovers, Koen P, Nienhuijs, Simon W, de Hingh, Ignace H
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501638/
https://www.ncbi.nlm.nih.gov/pubmed/28721098
http://dx.doi.org/10.2147/CMAR.S119569
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author Simkens, Geert A
Rovers, Koen P
Nienhuijs, Simon W
de Hingh, Ignace H
author_facet Simkens, Geert A
Rovers, Koen P
Nienhuijs, Simon W
de Hingh, Ignace H
author_sort Simkens, Geert A
collection PubMed
description Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a viable option for selected patients with peritoneal metastases (PM) from colorectal origin, resulting in long-term survival and even cure in some cases. However, adequate patient selection for this treatment is currently one of the major challenges. The aim of this review is to provide a comprehensive overview of clinically relevant factors associated with overall survival. This may help to guide clinicians through the complex interplay of patient, tumor, and treatment characteristics to adequately select patients who benefit the most from this extensive surgical treatment. First, basic principles of colorectal PM and the CRS and HIPEC treatment will be discussed. According to available literature, especially extent of peritoneal disease, completeness of cytoreduction, and signet ring cell histology have great influence on the outcome after CRS and HIPEC. Other factors that seem to have a negative prognostic value are the presence of liver metastases and the absence of treatment with neo-adjuvant systemic therapy. Prognostic models combining the above-mentioned factors, such as the Colorectal Peritoneal Metastases Prognostic Surgical Score nomogram, may provide clinically relevant tools to use in everyday practice.
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spelling pubmed-55016382017-07-18 Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer Simkens, Geert A Rovers, Koen P Nienhuijs, Simon W de Hingh, Ignace H Cancer Manag Res Review Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is a viable option for selected patients with peritoneal metastases (PM) from colorectal origin, resulting in long-term survival and even cure in some cases. However, adequate patient selection for this treatment is currently one of the major challenges. The aim of this review is to provide a comprehensive overview of clinically relevant factors associated with overall survival. This may help to guide clinicians through the complex interplay of patient, tumor, and treatment characteristics to adequately select patients who benefit the most from this extensive surgical treatment. First, basic principles of colorectal PM and the CRS and HIPEC treatment will be discussed. According to available literature, especially extent of peritoneal disease, completeness of cytoreduction, and signet ring cell histology have great influence on the outcome after CRS and HIPEC. Other factors that seem to have a negative prognostic value are the presence of liver metastases and the absence of treatment with neo-adjuvant systemic therapy. Prognostic models combining the above-mentioned factors, such as the Colorectal Peritoneal Metastases Prognostic Surgical Score nomogram, may provide clinically relevant tools to use in everyday practice. Dove Medical Press 2017-06-30 /pmc/articles/PMC5501638/ /pubmed/28721098 http://dx.doi.org/10.2147/CMAR.S119569 Text en © 2017 Simkens et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Simkens, Geert A
Rovers, Koen P
Nienhuijs, Simon W
de Hingh, Ignace H
Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title_full Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title_fullStr Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title_full_unstemmed Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title_short Patient selection for cytoreductive surgery and HIPEC for the treatment of peritoneal metastases from colorectal cancer
title_sort patient selection for cytoreductive surgery and hipec for the treatment of peritoneal metastases from colorectal cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5501638/
https://www.ncbi.nlm.nih.gov/pubmed/28721098
http://dx.doi.org/10.2147/CMAR.S119569
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