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Management of colorectal peritoneal metastases: Expert opinion

Abstract : When peritoneal metastases are diagnosed (strong agreement of experts): (i) seek advice from a multidisciplinary coordination meeting (MCM) with large experience in peritoneal disease (e.g. BIG RENAPE network); (ii) transfer (or not) the patient to a referral center with experience in hyperthermic intraperitoneal chemotherapy (HIPEC), according to the advice of the MCM. With regard to systemic chemotherapy (strong agreement of experts): (i) it should be performed both before and after surgery, (ii) for no longer than 6 months; (iii) without postoperative anti-angiogenetic drugs. With regard to cytoreductive surgery (strong agreement of experts): (i) Radical surgery requires a xiphopubic midline incision; (ii) no cytoreductive surgery via laparoscopy. With regard to HIPEC: HIPEC can be proposed for trials outside an HIPEC referral center (weak agreement between experts): (i) if surgery is radical; (ii) if the expected morbidity is "reasonable"; (iii) if the indication for HIPEC was suggested by a MCM, and; (iv) mitomycin is preferred to oxaliplatin (which cannot be recommended) for this indication.
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Submitted on : Wednesday, July 20, 2022 - 8:20:01 PM
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K. Abboud, T. André, M. Brunel, M. Ducreux, C. Eveno, et al.. Management of colorectal peritoneal metastases: Expert opinion. Journal of Visceral Surgery, Elsevier, 2019, 156, pp.377 - 379. ⟨10.1016/j.jviscsurg.2019.08.002⟩. ⟨hal-03489199⟩



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