DOI QR코드

DOI QR Code

Recent Update on the Treatment of Colorectal Peritoneal Metastasis: A Surgical Perspective

  • Hye Jung Cho (Division of Coloproctology, Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Woo Ram Kim (Division of Coloproctology, Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine)
  • Received : 2022.10.31
  • Accepted : 2022.11.16
  • Published : 2022.12.01

Abstract

Colorectal peritoneal metastasis has been an incurable disease for centuries. However, since the new millennium, recent advancements in therapies are achieved with modern chemotherapeutic agents, target agents, and immune checkpoint blockade introduction. Modern chemotherapies, from a nearly nonexistent median survival if untreated, have raised the duration to 16 months with target agents. Experts have once again surpassed its limit by introducing intraperitoneal chemotherapy and cytoreductive surgery (CRS). Numerous clinical trials regarding CRS and hyperthermic intraperitoneal chemotherapy have now opened new doors in peritoneal carcinomatosis treatment, even securing complete remission. In addition, up-to-date modalities, such as pressurized intraperitoneal aerosol chemotherapy and immunotherapies, showed promising results at an early stage.

Keywords

References

  1. Verwaal VJ, van Ruth S, de Bree E, et al. Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol 2003;21:3737-3743. https://doi.org/10.1200/JCO.2003.04.187
  2. Goere D, Glehen O, Quenet F, et al. Second-look surgery plus hyperthermic intraperitoneal chemotherapy versus surveillance in patients at high risk of developing colorectal peritoneal metastases (PROPHYLOCHIP-PRODIGE 15): a randomised, phase 3 study. Lancet Oncol 2020;21:1147-1154. https://doi.org/10.1016/S1470-2045(20)30322-3
  3. Klaver CEL, Wisselink DD, Punt CJA, et al. Adjuvant hyperthermic intraperitoneal chemotherapy in patients with locally advanced colon cancer (COLOPEC): a multicentre, open-label, randomised trial. Lancet Gastroenterol Hepatol 2019;4:761-770. https://doi.org/10.1016/S2468-1253(19)30239-0
  4. Quenet F, Elias D, Roca L, et al. Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy versus cytoreductive surgery alone for colorectal peritoneal metastases (PRODIGE 7): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 2021;22:256-266. https://doi.org/10.1016/S1470-2045(20)30599-4
  5. Korea Central Cancer Registry. 2019 National cancer registry statistics reference. 2021. https://ncc.re.kr/cancerStatsView.ncc?bbsnum=578&searchKey=total&searchValue=&pageNum=1 (accessed November 20, 2022).
  6. Hur H, Oh CM, Won YJ, Oh JH, Kim NK. Characteristics and survival of Korean patients with colorectal cancer based on data From the Korea Central Cancer Registry data. Ann Coloproctol 2018;34:212-221. https://doi.org/10.3393/ac.2018.08.02.1
  7. Zani S, Papalezova K, Stinnett S, Tyler D, Hsu D, Blazer DG 3rd. Modest advances in survival for patients with colorectal-associated peritoneal carcinomatosis in the era of modern chemotherapy. J Surg Oncol 2013;107:307-311. https://doi.org/10.1002/jso.23222
  8. Vogel JD, Felder SI, Bhama AR, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of colon cancer. Dis Colon Rectum 2022;65:148-177. https://doi.org/10.1097/DCR.0000000000002323
  9. Jayne DG, Fook S, Loi C, Seow-Choen F. Peritoneal carcinomatosis from colorectal cancer. Br J Surg 2002;89:1545-1550. https://doi.org/10.1046/j.1365-2168.2002.02274.x
  10. Fong Y, Cohen AM, Fortner JG, et al. Liver resection for colorectal metastases. J Clin Oncol 1997;15:938-946. https://doi.org/10.1200/JCO.1997.15.3.938
  11. Sugarbaker PH. Management of peritoneal-surface malignancy: the surgeon's role. Langenbecks Arch Surg 1999;384:576-587. https://doi.org/10.1007/s004230050246
  12. Elias D, Delperro JR, Sideris L, et al. Treatment of peritoneal carcinomatosis from colorectal cancer: impact of complete cytoreductive surgery and difficulties in conducting randomized trials. Ann Surg Oncol 2004;11:518-521. https://doi.org/10.1245/ASO.2004.09.008
  13. Sugarbaker PH, Van der Speeten K, Stuart OA. Pharmacologic rationale for treatments of peritoneal surface malignancy from colorectal cancer. World J Gastrointest Oncol 2010;2:19-30. https://doi.org/10.4251/wjgo.v2.i1.19
  14. Gonzalez-Moreno S, Gonzalez-Bayon LA, Ortega-Perez G. Hyperthermic intraperitoneal chemotherapy: rationale and technique. World J Gastrointest Oncol 2010;2:68-75. https://doi.org/10.4251/wjgo.v2.i2.68
  15. de Bree E, Witkamp AJ, Zoetmulder FA. Intraperitoneal chemotherapy for colorectal cancer. J Surg Oncol 2002;79:46-61. https://doi.org/10.1002/jso.10016
  16. Fujimoto S, Takahashi M, Kobayashi K, et al. Cytohistologic assessment of antitumor effects of intraperitoneal hyperthermic perfusion with mitomycin C for patients with gastric cancer with peritoneal metastasis. Cancer 1992;70:2754-2760. https://doi.org/10.1002/1097-0142(19921215)70:12<2754::aidcncr2820701205>3.0.co;2-a
  17. Los G, Verdegaal EM, Mutsaers PH, McVie JG. Penetration of carboplatin and cisplatin into rat peritoneal tumor nodules after intraperitoneal chemotherapy. Cancer Chemother Pharmacol 1991;28:159-165. https://doi.org/10.1007/BF00685503
  18. Ozols RF, Locker GY, Doroshow JH, Grotzinger KR, Myers CE, Young RC. Pharmacokinetics of adriamycin and tissue penetration in murine ovarian cancer. Cancer Res 1979;39:3209-3214.
  19. Panteix G, Guillaumont M, Cherpin L, et al. Study of the pharmacokinetics of mitomycin C in humans during intraperitoneal chemohyperthermia with special mention of the concentration in local tissues. Oncology 1993;50:366-370. https://doi.org/10.1159/000227211
  20. Sugarbaker PH. Intraperitoneal chemotherapy and cytoreductive surgery for the prevention and treatment of peritoneal carcinomatosis and sarcomatosis. Semin Surg Oncol 1998;14:254-261. https://doi.org/10.1002/(sici)1098-2388(199804/05)14:3<254::aid-ssu10>3.0.co;2-u
  21. Sugarbaker PH. Surgical management of carcinomatosis from colorectal cancer. Clin Colon Rectal Surg 2005;18:190-203. https://doi.org/10.1055/s-2005-916280
  22. Verwaal VJ, Bruin S, Boot H, van Slooten G, van Tinteren H. 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer. Ann Surg Oncol 2008;15:2426-2432. https://doi.org/10.1245/s10434-008-9966-2
  23. Franko J, Ibrahim Z, Gusani NJ, Holtzman MP, Bartlett DL, Zeh HJ 3rd. Cytoreductive surgery and hyperthermic intraperitoneal chemoperfusion versus systemic chemotherapy alone for colorectal peritoneal carcinomatosis. Cancer 2010;116:3756-3762. https://doi.org/10.1002/cncr.25116
  24. Elias D, Lefevre JH, Chevalier J, et al. Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin. J Clin Oncol 2009;27:681-685. https://doi.org/10.1200/JCO.2008.19.7160
  25. van Driel WJ, Koole SN, Sikorska K, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer. N Engl J Med 2018;378:230-240. https://doi.org/10.1056/NEJMoa1708618
  26. Pereira F, Serrano A, Manzanedo I, et al. GECOP-MMC: phase IV randomized clinical trial to evaluate the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) with mytomicin-C after complete surgical cytoreduction in patients with colon cancer peritoneal metastases. BMC Cancer 2022;22:536. https://doi.org/10.1186/s12885-022-09572-7
  27. Rossi AJ, Khan TM, Rehman SU, Nash GM, Hernandez JM. Early postoperative intraperitoneal versus hyperthermic intraperitoneal chemotherapy after optimal cytoreductive surgery for colorectal cancer with isolated peritoneal metastasis (ICARuS). Ann Surg Oncol 2021;28:4100-4101. https://doi.org/10.1245/s10434-021-10110-1
  28. Elias D, Honore C, Ciuchendea R, et al. Peritoneal pseudomyxoma: results of a systematic policy of complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Br J Surg 2008;95:1164-1171. https://doi.org/10.1002/bjs.6235
  29. Glehen O, Osinsky D, Cotte E, et al. Intraperitoneal chemohyperthermia using a closed abdominal procedure and cytoreductive surgery for the treatment of peritoneal carcinomatosis: morbidity and mortality analysis of 216 consecutive procedures. Ann Surg Oncol 2003;10:863-869. https://doi.org/10.1245/aso.2003.01.018
  30. Loungnarath R, Causeret S, Bossard N, et al. Cytoreductive surgery with intraperitoneal chemohyperthermia for the treatment of pseudomyxoma peritonei: a prospective study. Dis Colon Rectum 2005;48:1372-1379. https://doi.org/10.1007/s10350-005-0045-5
  31. Witkamp AJ, de Bree E, Kaag MM, van Slooten GW, van Coevorden F, Zoetmulder FA. Extensive surgical cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei. Br J Surg 2001;88:458-463. https://doi.org/10.1046/j.1365-2168.2001.01701.x
  32. Demtroder C, Solass W, Zieren J, Strumberg D, GigerPabst U, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy with oxaliplatin in colorectal peritoneal metastasis. Colorectal Dis 2016;18:364-371. https://doi.org/10.1111/codi.13130
  33. Girshally R, Demtroder C, Albayrak N, Zieren J, Tempfer C, Reymond MA. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) as a neoadjuvant therapy before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Surg Oncol 2016;14:253. https://doi.org/10.1186/s12957-016-1008-0