Management of colorectal peritoneal metastases: Expert opinion

Publication date: Available online 26 August 2019Source: Journal of Visceral SurgeryAuthor(s): K. Abboud, T. André, M. Brunel, M. Ducreux, C. Eveno, O. Glehen, D. Goéré, J.-M. Gornet, J.H. Lefevre, P. Mariani, A. Pinto, F. Quenet, O. Sgarbura, M. Ychou, M. PocardSummaryWhen peritoneal metastases are diagnosed (strong agreement of experts): (i) seek advice from a multidisciplinary coordination meeting (MCM) with large experience in peritoneal disease (e.g. BIG RENAPE network); (ii) transfer (or not) the patient to a referral center with experience in hyperthermic intraperitoneal chemotherapy (HIPEC), according to the advice of the MCM. With regard to systemic chemotherapy (strong agreement of experts): (i) it should be performed both before and after surgery, (ii) for no longer than 6 months; (iii) without postoperative anti-angiogenetic drugs. With regard to cytoreductive surgery (strong agreement of experts): (i) Radical surgery requires a xiphopubic midline incision; (ii) no cytoreductive surgery via laparoscopy. With regard to HIPEC: HIPEC can be proposed for trials outside an HIPEC referral center (weak agreement between experts): (i) if surgery is radical; (ii) if the expected morbidity is “reasonable”; (iii) if the indication for HIPEC was suggested by a MCM, and; (iv) mitomycin is preferred to oxaliplatin (which cannot be recommended) for this indication.
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research