Role of multi-modality therapy in peritoneal carcinomatosis and visceral metastasis: a case report and review of the literature

Table 1 Review of literature demonstrates four studies which evaluated prognostic factors for colorectal cancer patients with peritoneal carcinomatosis (PC) and hepatic metastasis (HM)

Article	Number of patients with PC and HM in study	PCI mean +/-SD (range)	Gilly classification (% of subjects)	Number of median HM	Number of simultaneous major liver resections	Number (%) of patients with CC0/CC1 or R0/R1	Overall survival (months)	Poor prognostic factor 1	Poor prognostic factor 2	Poor prognostic factor 3	Poor prognostic factor 4	Findings
Carmignani 2004 [8]*	16	-	-	-	-	15 (55%)	15	PCI ≥13	>2.5 mm of residual disease	-	-	No difference in survival comparing HM to PC patients
Kianmanesh 2007 [10]	16	-	III (14%) IV (63%)	-	3	30 (70%)	36	Gilly 3 or 4	>5 mm of residual disease	-	-	Addition of HM resection to PC treatment did not influence survival compared to PC treatment alone.
Varbaan 2009 [12]	14	-	-	1	2	9 (64%)	23	No prognostic factors identified on univariate analysis.	-	-	-
Maggiori 2013 [14]	37	11 (1-26)	-	6	12	37 (100%)	32	PCI ≥12	LN status of primary cancer	No postoperative systemic chemotherapy	Synchronous resection of PC and HM	Prolonged survival can be achieved with CRS and HIPEC in patients with PCI <12 and HM <3.

As seen in studies evaluating CRS and HIPEC in PC patients only, the principal prognostic factors (1, 2, 3, 4) for patients with PC and HM were extent of peritoneal involvement and adequacy of resection.
^*Though the majority of patients had both PC and HM, the authors did not differentiate patients with PC and HM from patients with PC and extra-hepatic metastasis in this study.
- Value not reported.
CC0: Complete Cytoreduction; CC1: near complete cytoreduction; CRS: Cytoreductive Surgery, HIPEC: Hyperthermic Intraperitoneal Chemotherapy; HM: Hepatic Metastasis, PC: Peritoneal Carcinomatosis, PCI: Peritoneal Carcinomatosis Index, LN: Lymph Node.

ISSN: 1477-7819