Surgical treatment provides new option for some colorectal cancer patients

Sep 30, 2008

Research out of Wake Forest University School of Medicine suggests that a surgical technique not traditionally used in advanced abdominal cancer may be a viable treatment option for some patients previously thought to be untreatable, offering the real possibility of extending survival for those patients.

The study, available online this month and scheduled to be published in an upcoming issue of Annals of Surgical Oncology, is the first to compare the success of techniques used to remove liver cancers to the effectiveness of those same techniques in removing cancers from the abdominal wall.

Peritoneal surface disease (PSD) appearing from the spread of colon cancer has not traditionally been considered treatable with surgery because of the difficulty of finding and removing all of the cancer, and has been treated with chemotherapy only, leaving those patients with a decreased prognosis and little hope for survival. The study prompts reconsideration of surgical treatment options in these patients and warrants further study into patient selection in this area, according to the lead researcher, Perry Shen, M.D.

The focus of the study was PSD, the development of colorectal cancer on the peritoneum, which is the lining of the abdominal wall. 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.

Shen, an associate professor of surgical oncology, and colleagues 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. They 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.

"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 Shen, a fellow in the American College of Surgeons. "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."

Nearly 50,000 people will die this year from colorectal cancer, according to the National Cancer Institute. An estimated 150,000 new cases will have been diagnosed in 2008.

"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 said. "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."

Source: Wake Forest University

Explore further: Colon cancer: Taking a step back to move forward

Related Stories

New tool on horizon for surgeons treating cancer patients

Jun 18, 2015

Surgeons could know while their patients are still on the operating table if a tissue is cancerous, according to researchers from the Department of Energy's Oak Ridge National Laboratory and Brigham and Women's ...

Virtual-twin plan could support surgery for soldiers

Feb 16, 2015

A Saturday story in the MIRROR.CO.UK, the online edition of the Daily Mirror, carried a headline that made readers look once, twice, three times: "'Virtual twins' could save lives as doctors prepare to te ...

New nanogel for drug delivery

Feb 19, 2015

Scientists are interested in using gels to deliver drugs because they can be molded into specific shapes and designed to release their payload over a specified time period. However, current versions aren't ...

Recommended for you

Protein's impact on colorectal cancer is dappled

3 hours ago

Researchers at University of California, San Diego School of Medicine have discovered a cell signaling pathway that appears to exert some control over initiation and progression of colorectal cancer, the ...

Colon cancer: Taking a step back to move forward

12 hours ago

Recent Weizmann Institute studies are revealing a complex picture of cancer progression in which certain genes that drive tumor growth in the earlier stages get suppressed in later stages - taking a step ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.