Gelli Maximiliano, Huguenin Janina Fl, Cerebelli Cecilia, Benhaim Léonor, Honoré Charles, Elias Dominique, Goéré Diane
Department of Surgical Oncology, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France.
Future Oncol. 2017 Apr;13(10):907-918. doi: 10.2217/fon-2016-0389. Epub 2017 Jan 5.
In the last decades, cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy became a curative option for peritoneal metastases in selected patients, otherwise considered for palliative therapy alone. Better knowledge of physiopathology of peritoneal spread and identification of predictive factors for peritoneal relapse prompted specialized centers to investigate the role of a 'proactive approach' in order to early detect peritoneal metastasis. These encouraging data could justify an active attitude in selected patients at high risk of peritoneal recurrence after curative resection of primary tumor. Selection criteria and the timing of complementary hyperthermic intraperitoneal chemotherapy remain important points of discussion. In this article, we will discuss treatment principles and future perspectives to early treat and, if possible, to prevent peritoneal dissemination after curative treatment of colorectal cancer.
在过去几十年中，减瘤手术联合腹腔内热灌注化疗成为特定患者腹膜转移的一种治愈性选择，否则这些患者仅被考虑进行姑息治疗。对腹膜播散病理生理学的更深入了解以及对腹膜复发预测因素的识别促使专业中心研究“积极治疗方法”的作用，以便早期发现腹膜转移。这些令人鼓舞的数据可以证明对原发性肿瘤根治性切除后腹膜复发高危的特定患者采取积极态度是合理的。选择标准和辅助腹腔内热灌注化疗的时机仍然是重要的讨论点。在本文中，我们将讨论治疗原则和未来前景，以便在结直肠癌根治性治疗后早期治疗并尽可能预防腹膜播散。
