{"entity":{"id":"colorectal-peritoneal-metastases","kind":"term","name":"Peritoneal metastases from bowel cancer","aka":["colorectal peritoneal metastases","peritoneal disease in bowel cancer","cytoreductive surgery and HIPEC for colorectal cancer","peritoneal carcinomatosis of colorectal origin"],"tldr":"Bowel cancer can seed the lining of the abdomen rather than travel to the liver or lungs. Where the deposits are confined to that lining and can all be removed, specialist centres offer an operation to strip them out. Adding heated chemotherapy into the abdomen at the end of that operation was tested in a randomised trial and did not help.","summary":"What it is and what is offered. Spread across the peritoneum, the membrane lining the abdominal cavity, is a distinct pattern of colorectal metastasis and responds poorly to systemic treatment. NICE NG151 (1.5.21) says that for people whose metastases are limited to the peritoneum, systemic anticancer therapy should be offered and the multidisciplinary team should discuss referral to a nationally commissioned specialist centre to consider cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.\n\nWhat the trial showed. PRODIGE 7 randomised 265 patients at 17 French centres, all of whom had achieved complete macroscopic resection or resection with less than 1 mm of residual tumour, to cytoreductive surgery with or without oxaliplatin hyperthermic intraperitoneal chemotherapy. After a median follow-up of 63.8 months, median overall survival was 41.7 months with the heated chemotherapy and 41.2 months without it (hazard ratio 1.00). Grade 3 or worse adverse events were similar at 30 days but more common in the hyperthermic arm at 60 days (26 against 15 percent). The authors concluded that cytoreductive surgery alone should be the cornerstone of curative-intent treatment (Quenet 2021). The 41-month median survival in both arms is the figure worth carrying: it is the surgery, and the selection of patients fit enough for it with disease complete enough to remove, that produces the outcome.\n\nHow to read a referral. Eligibility in the trial required a Peritoneal Cancer Index of 25 or less, performance status 0 or 1, and fitness for six months of systemic chemotherapy. The general glossary term for peritoneal metastasis covers the same pattern in stomach and other cancers, where the trial evidence is different.","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Peritoneal_carcinomatosis","links":[{"label":"NICE NG151: colorectal cancer, recommendations (Lynch 1.1, local disease 1.3, biomarkers 1.4, metastatic disease 1.5, ongoing care and support including follow-up 1.6)","url":"https://www.nice.org.uk/guidance/ng151/chapter/Recommendations"},{"label":"Quenet, Lancet Oncol 2021: PRODIGE 7, cytoreductive surgery with or without hyperthermic intraperitoneal chemotherapy for colorectal peritoneal metastases (265 patients)","url":"https://doi.org/10.1016/s1470-2045(20)30599-4"}],"tags":["gi","colorectal"],"related":[],"cancers":["colorectal","colon-cancer","rectal-cancer","appendiceal-adenocarcinoma"],"sections":[],"technologies":["hipec","ct"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["peritoneal-metastasis","liver-limited-metastatic-colorectal","conversion-therapy-colorectal","cytoreductive-surgery","peritoneal-carcinomatosis-index"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Clinical"},"route":"/terms/colorectal-peritoneal-metastases/","neighbours":{"cancer":[{"id":"appendiceal-adenocarcinoma","kind":"cancer","name":"Appendiceal adenocarcinoma (mucinous and non-mucinous, including signet ring cell)","route":"/cancers/appendiceal-adenocarcinoma/"},{"id":"colon-cancer","kind":"cancer","name":"Colon cancer (adenocarcinoma of the colon)","route":"/cancers/colon-cancer/"},{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"rectal-cancer","kind":"cancer","name":"Rectal cancer","route":"/cancers/rectal-cancer/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"hipec","kind":"technology","name":"HIPEC / PIPAC (intraperitoneal chemotherapy)","route":"/technologies/hipec/"}],"term":[{"id":"conversion-therapy-colorectal","kind":"term","name":"Conversion therapy in bowel cancer","route":"/terms/conversion-therapy-colorectal/"},{"id":"cytoreductive-surgery","kind":"term","name":"Cytoreductive surgery","route":"/terms/cytoreductive-surgery/"},{"id":"liver-limited-metastatic-colorectal","kind":"term","name":"Liver-limited metastatic bowel cancer","route":"/terms/liver-limited-metastatic-colorectal/"},{"id":"peritoneal-carcinomatosis-index","kind":"term","name":"Peritoneal cancer index","route":"/terms/peritoneal-carcinomatosis-index/"},{"id":"peritoneal-metastasis","kind":"term","name":"Peritoneal metastasis","route":"/terms/peritoneal-metastasis/"}]}}