title: [Principles of the treatment of peritoneal carcinomatosis due to colorectal cancer. Current review and update].
abstract: Colorectal cancer is the most frequent digestive tumor. The incidence of abdominal dissemination is high and all studies of the natural history of colorectal carcinomatosis demonstrate that prognosis in these patients is poor, with a mean survival of between 5 and 9 months. Furthermore, the results of systemic adjuvant treatment are disappointing, with a maximum survival of 18 months. Consequently, other treatment strategies need to be studied and developed. We present a review of the principles that underlie Sugarbakers treatment protocol, which includes maximal cytoreductive surgery for the treatment of macroscopic disease through peritonectomy together with perioperative intraperitoneal intensification chemotherapy for residual microscopic disease. We present all the phase II studies with more than 10 treated patients published in the medical literature by the main groups working in this line of treatment, together with the only phase III study published to date. With this new therapeutic alternative, the mean overall survival at 2 and 5 years is 40% and 20% respectively. Based on these results, this new therapeutic approach is recommended as the treatment of choice in these unfortunate patients. The limits of the treatment of advanced colorectal cancer are also discussed.
authors.affiliation: Programa de Carcinomatosis Peritoneal, Servicio de Cirugía, Policlínica San José, Vitoria, Alava, Spain. agomezpor@teleline.es
authors.forename: Alberto
authors.initials: A
authors.lastname: Gómez-Portilla
authors.forename: Iñaki
authors.initials: I
authors.lastname: Cendoya
authors.forename: Iñaki
authors.initials: I
authors.lastname: López de Tejada
authors.forename: Iñaki
authors.initials: I
authors.lastname: Olabarria
authors.forename: Luis
authors.initials: L
authors.lastname: Magrach
authors.forename: Concepción
authors.initials: C
authors.lastname: Martínez de Lecea
authors.forename: Alberto
authors.initials: A
authors.lastname: Gil
authors.forename: Mercedes
authors.initials: M
authors.lastname: Valdovinos
authors.forename: Iñaki
authors.initials: I
authors.lastname: Larrabide
authors.forename: Natalia
authors.initials: N
authors.lastname: Ruiz de Alegría
authors.forename: José Luis
authors.initials: JL
authors.lastname: Fernández
authors.forename: Irune
authors.initials: I
authors.lastname: Cachorro
authors.forename: María del Carmen
authors.initials: Mdel C
authors.lastname: Contreras
authors.forename: Josu
authors.initials: J
authors.lastname: Castañeda
authors.forename: Arantxa
authors.initials: A
authors.lastname: Uriarte
authors.forename: María Victoria
authors.initials: MV
authors.lastname: Boado
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Urturi
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Ulibarrena
mesh_terms: D002277:Carcinoma / Q000556:secondary* / Q000628:therapy*; D002986:Clinical Trials as Topic; D015179:Colorectal Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D006801:Humans; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy*