Turner Kevin M, Morris Mackenzie C, Sohal Davendra, Sussman Jeffrey J, Wilson Gregory C, Ahmad Syed A, Patel Sameer H
Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0558, USA.
Department of Internal Medicine, Division of Hematology & Oncology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0558, USA.
J Clin Med. 2022 Jun 14;11(12):3406. doi: 10.3390/jcm11123406.
The peritoneal cavity is a common site of metastatic spread from colorectal cancer (CRC). Patients with peritoneal metastases (PM) often have aggressive underlying tumor biology and poor survival. While only a minority of patients with CRC have potentially resectable disease, the high overall incidence of CRC makes management of PM a common clinical problem. In this population, cytoreductive surgery (CRS)-hyperthermic intraperitoneal chemotherapy (HIPEC) is the only effective therapy for appropriately selected patients. In this narrative review, we summarize the existing literature on CRS-HIPEC in colorectal PM. Recent prospective clinical trials have shown conflicting evidence regarding the benefit of HIPEC perfusion in addition to CRS. Current strategies to prevent PM in those at high-risk have been shown to be ineffective. Herein we will provide a framework for clinicians to understand and apply these data to treat this complex disease presentation.
腹膜腔是结直肠癌（CRC）转移扩散的常见部位。有腹膜转移（PM）的患者通常具有侵袭性的潜在肿瘤生物学特性，生存率低。虽然只有少数CRC患者有潜在可切除的疾病，但CRC的总体发病率较高，使得PM的管理成为一个常见的临床问题。在这一人群中，细胞减灭术（CRS）-热灌注化疗（HIPEC）是唯一适用于适当选择患者的有效治疗方法。在这篇叙述性综述中，我们总结了关于CRS-HIPEC治疗结直肠癌PM的现有文献。最近的前瞻性临床试验显示，关于除CRS外HIPEC灌注的益处存在相互矛盾的证据。目前在高危人群中预防PM的策略已被证明无效。在此，我们将为临床医生提供一个框架，以理解并应用这些数据来治疗这种复杂的疾病表现。
