title: Intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases: an updated systematic review.
abstract: We aimed to assess the efficacy and safety of delivering intraperitoneal chemotherapy and cytoreductive surgery for peritoneal metastases coupled with curative treatment of colorectal liver metastases. Areas covered: A comprehensive literature search using PubMed was conducted to screen for eligible records. Studies evaluating colorectal surgery and intraperitoneal chemotherapy combined with curative treatment of liver metastases were included. We excluded duplicate publications. Sixty-seven full-text papers were assessed and six papers were finally included. The overall survival in the included studies ranged from 6-49 months. Five-year survival ranged from 18%-28%, three-year survival ranged from 22%-42% and two-year survival ranged from 34%-78%. Survival was lower in patients with liver metastases and peritoneal carcinomatosis (PC) than those with PC alone in the majority of studies. Expert commentary: This review poses questions rather than presenting answers. The heterogeneity of survival data suggests the possible benefit of this aggressive treatment approach in selected patients. Standardization of the technique used for intraperitoneal chemotherapy instillation, agent used as well as the systemic chemotherapy and targeted therapy type and duration through prospective controlled trials is required to provide an evidence of a higher strength to support or prohibit this treatment strategy.
authors.affiliation: a Internal Medicine Department, Gastroenterology and Hepatology Division, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Sarah
authors.initials: S
authors.lastname: El-Nakeep
authors.affiliation: b Medical Oncology department , Maadi Military hospital , Cairo , Egypt.
authors.forename: Noha
authors.initials: N
authors.lastname: Rashad
authors.affiliation: c Department of Surgery, Swiss Cancer institute , Zurich , Switzerland.|d Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany.
authors.forename: Hani
authors.initials: H
authors.lastname: Oweira
authors.affiliation: d Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.affiliation: e Department of Surgery , OncoCentrum Zurich, Gastrointestinal Tumor Center Zurich (GITZ) , Zurich , Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Helbling
authors.affiliation: c Department of Surgery, Swiss Cancer institute , Zurich , Switzerland.
authors.forename: Anwar
authors.initials: A
authors.lastname: Giryes
authors.affiliation: e Department of Surgery , OncoCentrum Zurich, Gastrointestinal Tumor Center Zurich (GITZ) , Zurich , Switzerland.
authors.forename: Ulf
authors.initials: U
authors.lastname: Petrausch
authors.affiliation: d Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany.
authors.forename: Arianeb
authors.initials: A
authors.lastname: Mehrabi
authors.affiliation: c Department of Surgery, Swiss Cancer institute , Zurich , Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Decker
authors.affiliation: c Department of Surgery, Swiss Cancer institute , Zurich , Switzerland.|f Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
authors.forename: Omar
authors.initials: O
authors.lastname: Abdel-Rahman
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D065426:Cytoreduction Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D020360:Neoadjuvant Therapy; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: HIPEC; colorectal cancer; combined modality; cytoreduction; hepatic resection; peritoneal carcinomatosis