The Wake Forest University School of Medicine study is the first to compare the efficacy of techniques that are used to remove liver cancers to the effectiveness of those same techniques in removing cancers from the abdominal wall.
The focus of the study was peritoneal surface disease (PSD), the development of colorectal cancer on the peritoneum.. Researchers wanted to know if survival rates similar to those of patients who undergo liver surgery for metastatic colorectal cancer could be achieved by performing surgery to treat patients for PSD from colorectal cancer.
Researchers compared the outcomes of surgical removal of liver metastases from colorectal cancer (which is accepted as the treatment of choice) to the surgical removal of PSD from colorectal cancer. The PSD removal was combined with intra-abdominal heated chemotherapy. The researchers found that patients who were able to undergo complete removal of all PSD, combined with heated chemotherapy inside the abdomen, had no significant difference in survival rates than liver metastases patients who underwent surgical removal. This showed that surgical removal is a viable possibility for some patients with PSD where it had not been considered a good option before, according to the researchers.
“Peritoneal involvement has been considered inoperable because it is not a well-defined anatomic area and the lack of accurate imaging makes operative planning uncertain,” said study member Perry Shen. “What we have found is though this technique is not a treatment option for everyone with PSD, it can produce long-term survival in select patients and should be considered as part of a multidisciplinary approach.”
“This type of occurrence of colorectal cancer is typically considered incurable ... but in some cases, we now know we can extend the survival rate,” Shen added. “We are trying to change current paradigms in oncology. Physicians should refer these patients to a center that has surgeons with this experience who can deal with peritoneal involvement.”