Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases Journal Article
| Authors: | Schultz, K. S.; Bansal, V. V.; Wach, M. M.; Bhutiani, N.; Godley, F. A.; Wang, J.; Waheed, M. T.; Buchheit, J. T.; Papai, E.; Campbell, S.; Schleimer, L. E.; Su, D. G.; Turaga, K. K.; Gunderson, C. G.; White, M. G.; Uppal, A.; Raghav, K. P. S.; Labow, D. M.; Sarpel, U.; Shergill, A. P.; Shen, J. P.; Eng, C.; Foote, M. B.; Baumgartner, J. M. |
| Article Title: | Consensus Guideline for the Management of Colorectal Cancer with Peritoneal Metastases |
| Abstract: | BackgroundThe peritoneum is a common site of metastases from colorectal cancer (CRC), yet controversy exists regarding optimal treatment strategies. These guidelines describe the results of a national consensus addressing the management of CRC with peritoneal metastases (CRC-PM).MethodsAn update of the 2018 Chicago Consensus Guidelines was conducted using a modified Delphi technique. Two rounds of voting were performed to assess agreement levels on two clinical management pathways regarding synchronous and metachronous CRC-PM. Supporting evidence was evaluated via rapid literature reviews.ResultsThe overall level of evidence was low in existing literature. Of 145 participants in the first round, 136 (96.8%) responded in the second round. Over 90% consensus was achieved in most pathway blocks. For both pathways, early referral to a peritoneal surface malignancy (PSM) center should be made for patients with CRC-PM. For the synchronous pathway, upfront cytoreductive surgery was de-emphasized in favor of systemic therapy. For the metachronous pathway, risk stratification via clinical and pathologic features was revised. For both pathways, surveillance strategies were added, including only a weak recommendation for circulating tumor DNA (ctDNA) testing given limited evidence of its utility in detecting and monitoring PM.ConclusionThe consensus-driven clinical pathways provide valuable guidance for the management of CRC-PM. There remains a need for high-quality evidence and prospective multicenter trials in this domain. |
| Keywords: | colorectal cancer; cytoreductive surgery; recurrence; colon cancer; guidelines; intraperitoneal chemotherapy; carcinomatosis; rectal cancer; follow-up; colon-cancer; randomized-trial; systemic chemotherapy; open-label; hyperthermic intraperitoneal chemotherapy; disease severity score; ctdna; peritoneal surface malignancies; peritoneal surface neoplasms; combining cytoreductive surgery |
| Journal Title: | Annals of Surgical Oncology |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Publication status: | Online ahead of print |
| Date Published: | 2025-01-01 |
| Online Publication Date: | 2025-01-01 |
| Language: | English |
| ACCESSION: | WOS:001516570400001 |
| DOI: | 10.1245/s10434-025-17363-0 |
| PROVIDER: | wos |
| Notes: | Review; Early Access -- Source: Wos |
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