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Analysis of tumoral evolution and prognostic factors of multi-site hepatic and peritoneal colorectal metastases processes : from the animal model to an international clinical study

Abstract : The synchronous presence of liver metastases (LM) and peritoneal carcinomatosis (PC)from colorectal cancer (CRC) is associated with poor outcome and is traditionally considered acontraindication to any surgical approach. However, few series reported a prolonged survival aftersurgical management, reaching 3 years in selected patients thus suggesting that a curative surgicalmanagement may be possible. To date, no standard management pathway has been established,especially if a major liver and peritoneal surgery has to be performed. We postulated that liverregeneration after liver resection could promote PC growth. We constructed an immunocompetentanimal model of limited PC. The objective of our study was to analyze the effects of major LR andliver regeneration after hepatectomy on peritoneal carcinomatosis growth and the associatedangiogenesis process. Furthermore, we have analyzed a prospective international cohort of patientsundergoing synchronous liver resection and cytoreductive surgery with HIPEC. The aim of this studywas to describe the outcomes, to identify variables potentially related to poor outcome, in order toestablish future guideline for the management of these patients, to optimize the selection of candidatesfor surgical treatment and determine the best surgical strategy.
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  • HAL Id : tel-02355111, version 1

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Rea Lo Dico. Analysis of tumoral evolution and prognostic factors of multi-site hepatic and peritoneal colorectal metastases processes : from the animal model to an international clinical study. Hematology. Université Sorbonne Paris Cité; Università degli studi La Sapienza (Rome), 2017. English. ⟨NNT : 2017USPCC318⟩. ⟨tel-02355111⟩

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