TY - JOUR
T1 - Effective strategies to predict survival of colorectal peritoneal metastases patients eligible for cytoreductive surgery and HIPEC
AU - Simkens, Geert A.
AU - Wintjens, Anne G.W.E.
AU - Rovers, Koen P.
AU - Nienhuijs, Simon W.
AU - de Hingh, Ignace H.
N1 - Publisher Copyright:
© 2021 Simkens et al.
PY - 2021
Y1 - 2021
N2 - Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), often combined with systemic therapy, can be offered to selected colorectal peritoneal metastases (PM) patients. However, clinical heterogeneity and the lack of high-level evidence challenges determination of the correct treatment strategy. This review aims to provide an overview of current strategies to predict survival of colorectal PM patients treated with CRS and HIPEC, guiding clinicians to select a suitable treatment-strategy and to inform patients about their prognosis. First, the prognostic relevance of several clinicopathological prognostic factors, such as extent of PM, location of primary tumor, histology type, and the presence of lymph node or liver metastases will be discussed. Subsequently, special attention will be given to recent developments in several aspects of tumor biology such as RAF/RAS mutations, circulating tumor DNA, immunoprofiling, and consensus molecular subtypes. Finally, currently available prognostic models to predict survival will be evaluated, concluding these models perform moderate to good, but most of them partly rely on intra-operative data. New insights in tumor biology, as well as the reliable assessment of extent of peritoneal disease by diffusion weighted MRI pose promising opportunities to establish an adequate and clinically meaningful preoperative prognostic model in the near future.
AB - Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), often combined with systemic therapy, can be offered to selected colorectal peritoneal metastases (PM) patients. However, clinical heterogeneity and the lack of high-level evidence challenges determination of the correct treatment strategy. This review aims to provide an overview of current strategies to predict survival of colorectal PM patients treated with CRS and HIPEC, guiding clinicians to select a suitable treatment-strategy and to inform patients about their prognosis. First, the prognostic relevance of several clinicopathological prognostic factors, such as extent of PM, location of primary tumor, histology type, and the presence of lymph node or liver metastases will be discussed. Subsequently, special attention will be given to recent developments in several aspects of tumor biology such as RAF/RAS mutations, circulating tumor DNA, immunoprofiling, and consensus molecular subtypes. Finally, currently available prognostic models to predict survival will be evaluated, concluding these models perform moderate to good, but most of them partly rely on intra-operative data. New insights in tumor biology, as well as the reliable assessment of extent of peritoneal disease by diffusion weighted MRI pose promising opportunities to establish an adequate and clinically meaningful preoperative prognostic model in the near future.
KW - Colorectal neoplasms
KW - Cytoreductive surgery
KW - Hyperthermic intraperitoneal chemotherapy
KW - Peritoneal metastases
KW - Prognosis
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=85110276564&partnerID=8YFLogxK
U2 - 10.2147/CMAR.S277912
DO - 10.2147/CMAR.S277912
M3 - Review article
AN - SCOPUS:85110276564
SN - 1179-1322
VL - 13
SP - 5239
EP - 5249
JO - Cancer Management and Research
JF - Cancer Management and Research
ER -