Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research
Colorectal peritoneal metastases (CPM) are associated with abbreviated survival and significantly impaired quality of life. In patients with CPM, radical multimodality treatment consisting of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/5180895 |
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| author | Foteini Stefania Koumpa Diamantis Xylas Maciej Konopka Dieter Galea Kirill Veselkov Anthony Antoniou Akash Mehta Reza Mirnezami |
| author_facet | Foteini Stefania Koumpa Diamantis Xylas Maciej Konopka Dieter Galea Kirill Veselkov Anthony Antoniou Akash Mehta Reza Mirnezami |
| author_sort | Foteini Stefania Koumpa |
| collection | DOAJ |
| description | Colorectal peritoneal metastases (CPM) are associated with abbreviated survival and significantly impaired quality of life. In patients with CPM, radical multimodality treatment consisting of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated oncological superiority over systemic chemotherapy alone. In highly selected patients undergoing CRS + HIPEC, overall survival of over 60% has been reported in some series. These are patients in whom the disease burden is limited and where the diagnosis is made at an early stage in the disease course. Early diagnosis and a deeper understanding of the biological mechanisms that regulate CPM are critical to refining patient selection for radical treatment, personalising therapeutic approaches, enhancing prognostication, and ultimately improving long-term survivorship. In the present study, we outline three broad themes which represent critical future research targets in CPM: (1) enhanced radiological strategies for early detection and staging; (2) identification and validation of translational biomarkers for diagnostic, prognostic, and therapeutic deployment; and (3) development of optimized approaches for surgical cytoreduction as well as more precise strategies for intraperitoneal drug selection and delivery. Herein, we provide a contemporary narrative review of the state of the art in these three areas. A systematic review in accordance with PRISMA guidelines was undertaken on all English language studies published between 2007 and 2017. In vitro and animal model studies were deemed eligible for inclusion in the sections pertaining to biomarkers and therapeutic optimisation, as these areas of research currently remain in the early stages of development. Acquired data were then divided into hierarchical thematic categories (imaging modalities, translational biomarkers (diagnostic/prognostic/therapeutic), and delivery techniques) and subcategories. An interactive sunburst figure is provided for intuitive interrogation of the CPM research landscape. |
| format | Article |
| id | doaj-art-6a3e96e9971049c1801cbc3bda7f4017 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-6a3e96e9971049c1801cbc3bda7f40172025-02-03T05:58:35ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/51808955180895Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational ResearchFoteini Stefania Koumpa0Diamantis Xylas1Maciej Konopka2Dieter Galea3Kirill Veselkov4Anthony Antoniou5Akash Mehta6Reza Mirnezami7Department of Surgery, Brighton & Sussex University Hospitals NHS Trust, Eastern Road, Brighton BN2 5BE, UKDepartment of Surgery, Basildon & Thurrock University Hospitals NHS Foundation Trust, Nethermayne, Basildon, Essex SS16 5NL, UKDepartment of General, Endocrine and Gastrointestinal Surgery and Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, PolandComputational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ, UKComputational and Systems Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Sir Alexander Fleming Building, South Kensington Campus, London SW7 2AZ, UKDepartment of Colorectal Surgery, St Mark’s Hospital, Watford Road, Middlesex, Harrow HA1 3UJ, UKDepartment of Colorectal Surgery, St Mark’s Hospital, Watford Road, Middlesex, Harrow HA1 3UJ, UKDepartment of Surgery & Cancer, Imperial College London, 10th Floor, QEQM Building, St Mary’s Hospital, South Wharf Road, London W2 1NY, UKColorectal peritoneal metastases (CPM) are associated with abbreviated survival and significantly impaired quality of life. In patients with CPM, radical multimodality treatment consisting of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has demonstrated oncological superiority over systemic chemotherapy alone. In highly selected patients undergoing CRS + HIPEC, overall survival of over 60% has been reported in some series. These are patients in whom the disease burden is limited and where the diagnosis is made at an early stage in the disease course. Early diagnosis and a deeper understanding of the biological mechanisms that regulate CPM are critical to refining patient selection for radical treatment, personalising therapeutic approaches, enhancing prognostication, and ultimately improving long-term survivorship. In the present study, we outline three broad themes which represent critical future research targets in CPM: (1) enhanced radiological strategies for early detection and staging; (2) identification and validation of translational biomarkers for diagnostic, prognostic, and therapeutic deployment; and (3) development of optimized approaches for surgical cytoreduction as well as more precise strategies for intraperitoneal drug selection and delivery. Herein, we provide a contemporary narrative review of the state of the art in these three areas. A systematic review in accordance with PRISMA guidelines was undertaken on all English language studies published between 2007 and 2017. In vitro and animal model studies were deemed eligible for inclusion in the sections pertaining to biomarkers and therapeutic optimisation, as these areas of research currently remain in the early stages of development. Acquired data were then divided into hierarchical thematic categories (imaging modalities, translational biomarkers (diagnostic/prognostic/therapeutic), and delivery techniques) and subcategories. An interactive sunburst figure is provided for intuitive interrogation of the CPM research landscape.http://dx.doi.org/10.1155/2019/5180895 |
| spellingShingle | Foteini Stefania Koumpa Diamantis Xylas Maciej Konopka Dieter Galea Kirill Veselkov Anthony Antoniou Akash Mehta Reza Mirnezami Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research Gastroenterology Research and Practice |
| title | Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research |
| title_full | Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research |
| title_fullStr | Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research |
| title_full_unstemmed | Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research |
| title_short | Colorectal Peritoneal Metastases: A Systematic Review of Current and Emerging Trends in Clinical and Translational Research |
| title_sort | colorectal peritoneal metastases a systematic review of current and emerging trends in clinical and translational research |
| url | http://dx.doi.org/10.1155/2019/5180895 |
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