Abordagem Terapêutica da Carcinomatose Peritoneal em doentes com Carcinoma Colorretal
Resumo
A carcinomatose peritoneal (CP) é uma fase avançada da evolução do carcinoma colorretal que está associada a um mau prognóstico. A CP era compreendida como uma doença incurável, o tratamento consistia numa abordagem meramente paliativa. Durante as últimas décadas sugiram novas opções terapêuticas; a cirurgia citorredutora combinada com a quimioterapia intraperitoneal foi proposta como possibilidade terapêutica em doentes com carcinomatose peritoneal com origem no carcinoma colorretal (CCR). Estudos recentes defendem que esta nova abordagem pode promover um aumento da sobrevida em doentes selecionados. O conceito consiste em interpretar a CP como uma metastização regional da doença, suscetível a tratamento locorregional. Contudo, o resultado obtido depende da seleção adequada dos doentes submetidos a esta abordagem terapêutica: doentes com doença peritoneal limitada em que se verifica uma citorredução completa, apresentam benefício. Nesta revisão serão discutidas as indicações, os aspetos técnicos, as limitações, os resultados obtidos e os desafios desta nova abordagem terapêutica nos doentes com carcinomatose peritoneal com origem no CCR.
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Referências
Chua, T.C., et al., Critical analysis of 33 patients with peritoneal carcinomatosis secondary to colorectal and appendiceal signet ring cell carcinoma. Ann Surg Oncol, 2009. 16(10): p. 2765 -70.
Sugarbaker, P.H., New responsibilities in the management of colorectal cancer with peritoneal seeding. Cancer Invest, 2002. 20(7-8): p. 1118-22.
Chua, T.C., et al., Summary of current therapeutic options for peritoneal metastases from colorectal cancer. J Surg Oncol, 2013. 107(6): p. 566 -73.
Gervais, M.K., et al., Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with oxaliplatin for peritoneal carcinomatosis arising from colorectal cancer. J Surg Oncol, 2013. 108(7): p. 438-43.
Brucher, B., et al., Patients at risk for peritoneal surface malignancy of colorectal cancer origin: the role of second look laparotomy. J Cancer, 2013. 4(3): p. 262-9.
Sugarbaker, P.H., Strategies for the prevention and treatment of peritoneal carcinomatosis from gastrointestinal cancer. Cancer Invest, 2005. 23(2): p. 155 -72.
Roviello, F., et al., Treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: state of the art and future developments. Surg Oncol, 2011. 20(1): p. e38-54.
Yonemura, Y., E. Canbay, and H. Ishibashi, Prognostic factors of peritoneal metastases from colorectal cancer following cytoreductive surgery and perioperative chemotherapy. ScientificWorldJournal, 2013. 2013: p. 978394.
Glockzin, G., et al., A prospective multicenter phase II study evaluating multimodality treatment of patients with peritoneal carcinomatosis arising from appendiceal and colorectal cancer: the COMBATAC trial. BMC Cancer, 2013. 13: p. 67.
Vaira, M., et al., Treatment of peritoneal carcinomatosis from colonic cancer by cytoreduction, peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Experience of ten years. In Vivo, 2010. 24(1): p. 79-84.
Cavaliere, F., et al., Prognostic factors and oncologic outcome in 146 patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: Italian multicenter study S.I.T.I.L.O. Eur J Surg Oncol, 2011. 37(2): p. 148-54.
Bretcha-Boix, P., et al., Cytoreductive surgery and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colonic origin: outcomes after 7 years’ experience of a new centre for peritoneal surface malignancies. Clin Transl Oncol, 2010. 12(6): p. 437-42.
Sommariva, A., P. Pilati, and C.R. Rossi, Cyto-reductive Surgery combined with Hyperthermic Intra-peritoneal Chemotherapy for Peritoneal Surface Malignancies: current treatment and results. Cancer Treat Rev, 2012. 38(4): p. 258-68.
Cashin, P.H., et al., Intraoperative hyperthermic versus postoperative normothermic intraperitoneal chemotherapy for colonic peritoneal carcinomatosis: a case-control study. Ann Oncol, 2012. 23(3): p. 647-52.
Confuorto, G., et al., Peritoneal carcinomatosis from colorectal cancer: HIPEC? Surg Oncol, 2007. 16 Suppl 1: p. S149-52.
Elias, D., et al., Comparison of two kinds of intraperitoneal chemotherapy following complete cytoreductive surgery of colorectal peritoneal carcinomatosis. Ann Surg Oncol, 2007. 14(2): p. 509-14.
Riss, S., et al., Peritoneal metastases from colorectal cancer: patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol, 2013. 39(9): p. 931-7.
Verwaal, V.J., et al., 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(9): p. 2426-32.
Hagendoorn, J., et al., Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal and gastrointestinal origin shows acceptable morbidity and high survival. Eur J Surg Oncol, 2009. 35(8): p. 833-7.
Cashin, P.H., et al., Comparison of prognostic scores for patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol, 2013. 20(13): p. 4183-9.
Hamilton, T., et al., Long-term follow-up in the treatment of peritoneal carcinomatosis. Am J Surg, 2011. 201(5): p. 65 0-4.
Elias, D., et al., Variation in the peritoneal cancer index scores between surgeons and according to when they are determined (before or after cytoreductive surgery). Eur J Surg Oncol, 2012. 38(6): p. 503-8.
Klaver, Y.L., et al., Outcomes of colorectal cancer patients with peritoneal carcinomatosis treated with chemotherapy with and without targeted therapy. Eur J Surg Oncol, 2012. 38(7): p. 617-23.
Ripley, R.T., et al., Prospective randomized trial evaluating mandatory second look surgery with HIPEC and CRS vs. standard of care in patients at high risk of developing colorectal peritoneal metastases. Trials, 2010. 11: p. 62.
Maggiori, L. and D. Elias, Curative treatment of colorectal peritoneal carcinomatosis: current status and future trends. Eur J Surg Oncol, 2010. 36(7): p. 599-603.
da Silva, R.G. and P.H. Sugarbaker, Analysis of prognostic factors in seventy patients having a complete cytoreduction plus perioperative intraperitoneal chemotherapy for carcinomatosis from colorectal cancer. J Am Coll Surg, 2006. 203(6): p. 878-86.
Song, W., et al., Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma: experience at an institution in southern China. Chin Med J (Engl), 2009. 122(13): p. 1486-91.
Winer, J., et al., Impact of aggressive histology and location of primary tumor on the efficacy of surgical therapy for peritoneal carcinomatosis of colorectal origin. Ann Surg Oncol, 2014. 21(5): p. 1456 -62.
Verwaal, V.J., et al., Predicting the survival of patients with peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intraperitoneal chemotherapy. Br J Surg, 2004. 91(6): p. 739-46.
Van Sweringen, H.L., et al., Predictors of survival in patients with high-grade peritoneal metastases undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Surgery, 2012. 152(4): p. 617-24; discussion 624-5.
Weber, T., M. Roitman, and K.H. Link, Current status of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis from colorectal cancer. Clin Colorectal Cancer, 2012. 11(3): p. 167-76.
Elias, D., et al., Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric French study. J Clin Oncol, 2010. 28(1): p. 63-8.
Schmidt, U., et al., Perioperative morbidity and quality of life in long-term survivors following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol, 2005. 31(1): p. 53-8.
Konigsrainer, I., et al., Experience after 100 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Gastroenterol, 2012. 18(17): p. 2061-6.
Tabrizian, P., et al., Outcomes for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the elderly. Surg Oncol, 2013. 22(3): p. 184-9.
Pestieau, S.R. and P.H. Sugarbaker, Treatment of primary colon cancer with peritoneal carcinomatosis: comparison of concomitant vs. delayed management. Dis Colon Rectum, 2000. 43(10): p. 1341-6; discussion 1347-8.
Culliford, A.T.t., et al., Surgical debulking and intraperitoneal chemotherapy for established peritoneal metastases from colon and appendix cancer. Ann Surg Oncol, 2001. 8(10): p. 787-95.
Elias, D., et al., Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer, 2001. 92(1): p. 71-6.
Verwaal, V.J., 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(20): p. 3737-43.
Glehen, O., et al., Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol, 2004. 22(16): p. 3284-92.
Verwaal, V.J., et al., Long-term survival of peritoneal carcinomatosis of colorectal origin. Ann Surg Oncol, 2005. 12(1): p. 65 -71.
Elias, D., et al., Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin. J Clin Oncol, 2009. 27(5): p. 681-5.
Hompes, D., et al., The treatment of peritoneal carcinomatosis of colorectal cancer with complete cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) with oxaliplatin: a Belgian multicentre prospective phase II clinical study. Ann Surg Oncol, 2012. 19(7): p. 2186-94.
Turrini, O., et al., Initial experience with hyperthermic intraperitoneal chemotherapy. Arch Surg, 2012. 147(10): p. 919-23.
Cashin, P.H., et al., Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: prognosis and treatment of recurrences in a cohort study. Eur J Surg Oncol, 2012. 38(6): p. 509-15.
Haslinger, M., et al., A contemporary analysis of morbidity and outcomes in cytoreduction/hyperthermic intraperitoneal chemoperfusion. Cancer Med, 2013. 2(3): p. 334-42.
Levine, E.A., et al., Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. J Am Coll Surg, 2014. 218(4): p. 573-85.
Passot, G., et al., Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: A prospective study of 216 patients. Eur J Surg Oncol, 2014. 40(5): p. 529-35.
Tsilimparis, N., et al., Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is it worth the risk? Ann Surg Oncol, 2013. 20(1): p. 226-32.
McQuellon, R.P., et al., Monitoring health outcomes following cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol, 2007. 14(3): p. 1105-13.
Zani, S., et al., Modest advances in survival for patients with colorectal associated peritoneal carcinomatosis in the era of modern chemotherapy. J Surg Oncol, 2013. 107(4): p. 307-11.
Sugarbaker, P.H., New responsibilities in the management of colorectal cancer with peritoneal seeding. Cancer Invest, 2002. 20(7-8): p. 1118-22.
Chua, T.C., et al., Summary of current therapeutic options for peritoneal metastases from colorectal cancer. J Surg Oncol, 2013. 107(6): p. 566 -73.
Gervais, M.K., et al., Cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy with oxaliplatin for peritoneal carcinomatosis arising from colorectal cancer. J Surg Oncol, 2013. 108(7): p. 438-43.
Brucher, B., et al., Patients at risk for peritoneal surface malignancy of colorectal cancer origin: the role of second look laparotomy. J Cancer, 2013. 4(3): p. 262-9.
Sugarbaker, P.H., Strategies for the prevention and treatment of peritoneal carcinomatosis from gastrointestinal cancer. Cancer Invest, 2005. 23(2): p. 155 -72.
Roviello, F., et al., Treatment of peritoneal carcinomatosis with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: state of the art and future developments. Surg Oncol, 2011. 20(1): p. e38-54.
Yonemura, Y., E. Canbay, and H. Ishibashi, Prognostic factors of peritoneal metastases from colorectal cancer following cytoreductive surgery and perioperative chemotherapy. ScientificWorldJournal, 2013. 2013: p. 978394.
Glockzin, G., et al., A prospective multicenter phase II study evaluating multimodality treatment of patients with peritoneal carcinomatosis arising from appendiceal and colorectal cancer: the COMBATAC trial. BMC Cancer, 2013. 13: p. 67.
Vaira, M., et al., Treatment of peritoneal carcinomatosis from colonic cancer by cytoreduction, peritonectomy and hyperthermic intraperitoneal chemotherapy (HIPEC). Experience of ten years. In Vivo, 2010. 24(1): p. 79-84.
Cavaliere, F., et al., Prognostic factors and oncologic outcome in 146 patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy: Italian multicenter study S.I.T.I.L.O. Eur J Surg Oncol, 2011. 37(2): p. 148-54.
Bretcha-Boix, P., et al., Cytoreductive surgery and perioperative intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colonic origin: outcomes after 7 years’ experience of a new centre for peritoneal surface malignancies. Clin Transl Oncol, 2010. 12(6): p. 437-42.
Sommariva, A., P. Pilati, and C.R. Rossi, Cyto-reductive Surgery combined with Hyperthermic Intra-peritoneal Chemotherapy for Peritoneal Surface Malignancies: current treatment and results. Cancer Treat Rev, 2012. 38(4): p. 258-68.
Cashin, P.H., et al., Intraoperative hyperthermic versus postoperative normothermic intraperitoneal chemotherapy for colonic peritoneal carcinomatosis: a case-control study. Ann Oncol, 2012. 23(3): p. 647-52.
Confuorto, G., et al., Peritoneal carcinomatosis from colorectal cancer: HIPEC? Surg Oncol, 2007. 16 Suppl 1: p. S149-52.
Elias, D., et al., Comparison of two kinds of intraperitoneal chemotherapy following complete cytoreductive surgery of colorectal peritoneal carcinomatosis. Ann Surg Oncol, 2007. 14(2): p. 509-14.
Riss, S., et al., Peritoneal metastases from colorectal cancer: patient selection for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol, 2013. 39(9): p. 931-7.
Verwaal, V.J., et al., 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(9): p. 2426-32.
Hagendoorn, J., et al., Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal and gastrointestinal origin shows acceptable morbidity and high survival. Eur J Surg Oncol, 2009. 35(8): p. 833-7.
Cashin, P.H., et al., Comparison of prognostic scores for patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol, 2013. 20(13): p. 4183-9.
Hamilton, T., et al., Long-term follow-up in the treatment of peritoneal carcinomatosis. Am J Surg, 2011. 201(5): p. 65 0-4.
Elias, D., et al., Variation in the peritoneal cancer index scores between surgeons and according to when they are determined (before or after cytoreductive surgery). Eur J Surg Oncol, 2012. 38(6): p. 503-8.
Klaver, Y.L., et al., Outcomes of colorectal cancer patients with peritoneal carcinomatosis treated with chemotherapy with and without targeted therapy. Eur J Surg Oncol, 2012. 38(7): p. 617-23.
Ripley, R.T., et al., Prospective randomized trial evaluating mandatory second look surgery with HIPEC and CRS vs. standard of care in patients at high risk of developing colorectal peritoneal metastases. Trials, 2010. 11: p. 62.
Maggiori, L. and D. Elias, Curative treatment of colorectal peritoneal carcinomatosis: current status and future trends. Eur J Surg Oncol, 2010. 36(7): p. 599-603.
da Silva, R.G. and P.H. Sugarbaker, Analysis of prognostic factors in seventy patients having a complete cytoreduction plus perioperative intraperitoneal chemotherapy for carcinomatosis from colorectal cancer. J Am Coll Surg, 2006. 203(6): p. 878-86.
Song, W., et al., Clinicopathologic features and survival of patients with colorectal mucinous, signet-ring cell or non-mucinous adenocarcinoma: experience at an institution in southern China. Chin Med J (Engl), 2009. 122(13): p. 1486-91.
Winer, J., et al., Impact of aggressive histology and location of primary tumor on the efficacy of surgical therapy for peritoneal carcinomatosis of colorectal origin. Ann Surg Oncol, 2014. 21(5): p. 1456 -62.
Verwaal, V.J., et al., Predicting the survival of patients with peritoneal carcinomatosis of colorectal origin treated by aggressive cytoreduction and hyperthermic intraperitoneal chemotherapy. Br J Surg, 2004. 91(6): p. 739-46.
Van Sweringen, H.L., et al., Predictors of survival in patients with high-grade peritoneal metastases undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Surgery, 2012. 152(4): p. 617-24; discussion 624-5.
Weber, T., M. Roitman, and K.H. Link, Current status of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis from colorectal cancer. Clin Colorectal Cancer, 2012. 11(3): p. 167-76.
Elias, D., et al., Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric French study. J Clin Oncol, 2010. 28(1): p. 63-8.
Schmidt, U., et al., Perioperative morbidity and quality of life in long-term survivors following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol, 2005. 31(1): p. 53-8.
Konigsrainer, I., et al., Experience after 100 patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. World J Gastroenterol, 2012. 18(17): p. 2061-6.
Tabrizian, P., et al., Outcomes for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the elderly. Surg Oncol, 2013. 22(3): p. 184-9.
Pestieau, S.R. and P.H. Sugarbaker, Treatment of primary colon cancer with peritoneal carcinomatosis: comparison of concomitant vs. delayed management. Dis Colon Rectum, 2000. 43(10): p. 1341-6; discussion 1347-8.
Culliford, A.T.t., et al., Surgical debulking and intraperitoneal chemotherapy for established peritoneal metastases from colon and appendix cancer. Ann Surg Oncol, 2001. 8(10): p. 787-95.
Elias, D., et al., Curative treatment of peritoneal carcinomatosis arising from colorectal cancer by complete resection and intraperitoneal chemotherapy. Cancer, 2001. 92(1): p. 71-6.
Verwaal, V.J., 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(20): p. 3737-43.
Glehen, O., et al., Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol, 2004. 22(16): p. 3284-92.
Verwaal, V.J., et al., Long-term survival of peritoneal carcinomatosis of colorectal origin. Ann Surg Oncol, 2005. 12(1): p. 65 -71.
Elias, D., et al., Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin. J Clin Oncol, 2009. 27(5): p. 681-5.
Hompes, D., et al., The treatment of peritoneal carcinomatosis of colorectal cancer with complete cytoreductive surgery and hyperthermic intraperitoneal peroperative chemotherapy (HIPEC) with oxaliplatin: a Belgian multicentre prospective phase II clinical study. Ann Surg Oncol, 2012. 19(7): p. 2186-94.
Turrini, O., et al., Initial experience with hyperthermic intraperitoneal chemotherapy. Arch Surg, 2012. 147(10): p. 919-23.
Cashin, P.H., et al., Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: prognosis and treatment of recurrences in a cohort study. Eur J Surg Oncol, 2012. 38(6): p. 509-15.
Haslinger, M., et al., A contemporary analysis of morbidity and outcomes in cytoreduction/hyperthermic intraperitoneal chemoperfusion. Cancer Med, 2013. 2(3): p. 334-42.
Levine, E.A., et al., Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients. J Am Coll Surg, 2014. 218(4): p. 573-85.
Passot, G., et al., Quality of life after cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy: A prospective study of 216 patients. Eur J Surg Oncol, 2014. 40(5): p. 529-35.
Tsilimparis, N., et al., Quality of life in patients after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is it worth the risk? Ann Surg Oncol, 2013. 20(1): p. 226-32.
McQuellon, R.P., et al., Monitoring health outcomes following cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis. Ann Surg Oncol, 2007. 14(3): p. 1105-13.
Zani, S., et al., Modest advances in survival for patients with colorectal associated peritoneal carcinomatosis in the era of modern chemotherapy. J Surg Oncol, 2013. 107(4): p. 307-11.
Publicado
2017-03-30
Como Citar
MOSCA, Ana Margarida Saraiva Santos; BARBOSA, Laura Elisabete.
Abordagem Terapêutica da Carcinomatose Peritoneal em doentes com Carcinoma Colorretal.
Revista Portuguesa de Cirurgia, [S.l.], n. 40, p. 35-50, mar. 2017.
ISSN 2183-1165.
Disponível em: <https://revista.spcir.com/index.php/spcir/article/view/443>. Acesso em: 25 mar. 2023.
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