MANEJO DE LA CARCINOMATOSIS PERITONEAL DE ORIGEN COLORRECTAL Y REALIDAD EN PANAMÁ

Olga Candanedo; Gabriela Casiano; Isabella Castillero; Moisés Cukier

Enviado octubre 28, 2024

Publicado 2026-02-02

Artículos de Investigación

Vol. 33 Núm. 1 (2020): Revista Médico Científica

MANEJO DE LA CARCINOMATOSIS PERITONEAL DE ORIGEN COLORRECTAL Y REALIDAD EN PANAMÁ

Olga Candanedo⁺⁻
Gabriela Casiano⁺⁻
Isabella Castillero⁺⁻
Moisés Cukier⁺⁻

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DOI: ND

Publicado: 2026-02-02

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

Antecedentes: En 1931, Sampson fue el primero en describir el término carcinomatosis peritoneal para referirse a la diseminación peritoneal de una neoplasia avanzada de ovario. Actualmente, engloba toda diseminación tumoral, masiva o regional, que involucra la serosa peritoneal y las estructuras anatómicas adyacentes. Cerca del 10% de los pacientes con carcinoma colorrectal presentan carcinomatosis peritoneal al momento del diagnóstico. Además, entre el 10% al 35% de los pacientes con recidiva presentarán lesiones exclusivamente a nivel peritoneal. En más de la mitad de estos pacientes el peritoneo es el primer y único sitio de metástasis.

Objetivo: Presentar la evidencia publicada sobre el abordaje y tratamiento quirúrgico de la carcinomatosis peritoneal de cáncer colorrectal en otras latitudes y como su implementación podría ofrecer un panorama prometedor para la calidad de vida de estos pacientes en Panamá.

Diseño: Se utilizaron artículos científicos indexados entre 2010 y 2020 que fueron seleccionados por su relevancia, validez y calidad de contenido; como aquellos disponibles en el: National Center for Biotechnology Information, Surgical Oncology Clinics of North America, Annals of Surgical Oncology, World Journal of Surgical Oncology; obtenidas a través de diversas bibliotecas virtuales.

Conclusión: La cirugía citorreductora en combinación con quimioterapia intraperitoneal hipertérmica ha mejorado la sobrevida global a los 5 años, de 40% a 51%, dando resultados prometedores en pacientes con carcinomatosis peritoneal de origen colorrectal altamente seleccionados; e incluso se considera el único tratamiento potencialmente curativo.

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Sánchez E, Espin F. Carcinomatosis peritoneal. Revisión de conjunto. Revista Médica de Trujillo. 2019 Apr 2;14(1).
Grass F, Vuagniaux A, Teixeira-Farinha H, Lehmann K, Demartines N, Hübner M. Systematic review of pressurized intraperitoneal aerosol chemotherapy for the treatment of advanced peritoneal carcinomatosis. British Journal of Surgery. 2017 May;104(6):669-78.
Kok N, de Hingh I. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases of colorectal origin. British Journal of Surgery. 2017;104(4):313-315.
Ministerio de Salud de Panamá. Registro Nacional de Cáncer de Panamá. (2012).
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Graniel-Palafox LE, Guerrero-Avendaño G. Vías de diseminación y sitios frecuentes de implantación metastásica en carcinomatosis peritoneal; hallazgos por tomografía. Anales de Radiología, Mexico. 2013 Jan 1;12(1).
McMullen JR, Selleck M, Wall NR, Senthil M. Peritoneal carcinomatosis: limits of diagnosis and the case for liquid biopsy. Oncotarget. 2017 Jun 27;8(26):43481.
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Flicek K, Ashfaq A, Johnson CD, Menias C, Bagaria S, Wasif N. Correlation of radiologic with surgical peritoneal cancer index scores in patients with pseudomyxoma peritonei and peritoneal carcinomatosis: how well can we predict resectability?. Journal of Gastrointestinal Surgery. 2016 Feb 1;20(2):307-12.
Goéré D, Souadka A, Faron M, Cloutier AS, Viana B, Honoré C, Dumont F, Elias D. Extent of colorectal peritoneal carcinomatosis: attempt to define a threshold above which HIPEC does not offer survival benefit: a comparative study. Annals of surgical oncology. 2015 Sep 1;22(9):2958-64.
López-Basave HN, Morales-Vásquez F, Luna Ortiz K, Méndez Herrera C, Ruiz-Molina JM. Citorreducción e HIPEC en carcinomatosis peritoneal. Experiencia del Instituto Nacional de Cancerología de México. Cirujano general. 2014;36(3):138-44.
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Winer J, Zenati M, Ramalingam L, Jones H, Zureikat A, Holtzman M, Lee K, Ahrendt S, Pingpank J, Zeh HJ, Bartlett DL. Impact of aggressive histology and location of primary tumor on the efficacy of surgical therapy for peritoneal carcinomatosis of colorectal origin. Annals of surgical oncology. 2014 May 1;21(5):1456-62.
Cashin PH, Graf W, Nygren P, Mahteme H. Comparison of prognostic scores for patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Annals of surgical oncology. 2013 Dec 1;20(13):4183-9.
Chua TC, Morris DL, Esquivel J. Impact of the peritoneal surface disease severity score on survival in patients with colorectal cancer peritoneal carcinomatosis undergoing complete cytoreduction and hyperthermic intraperitoneal chemotherapy. Annals of Surgical Oncology. 2010 May 1;17(5):1330-6.
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Yong ZZ, Tan GH, Shannon N, Chia C, Teo MC. PROPS—A novel Pre-Operative Predictive Score for unresectability in patients with colorectal peritoneal metastases being considered for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). World journal of surgical oncology. 2019 Dec 1;17(1):138.
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[1] Breton C, Pertuz JE, Calderón D, Angulo J, Pacheco M. Manejo de carcinomatosis peritoneal con citorreducción más quimioterapia hipertérmica intraoperatoria (HIPEC). Revista Repertorio de Medicina y Cirugía. 2020 Jan 30;29(1).

[2] Sánchez E, Espin F. Carcinomatosis peritoneal. Revisión de conjunto. Revista Médica de Trujillo. 2019 Apr 2;14(1).

[3] Grass F, Vuagniaux A, Teixeira-Farinha H, Lehmann K, Demartines N, Hübner M. Systematic review of pressurized intraperitoneal aerosol chemotherapy for the treatment of advanced peritoneal carcinomatosis. British Journal of Surgery. 2017 May;104(6):669-78.

[4] Kok N, de Hingh I. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases of colorectal origin. British Journal of Surgery. 2017;104(4):313-315.

[5] Ministerio de Salud de Panamá. Registro Nacional de Cáncer de Panamá. (2012).

[6] González D, Ruso Martínez L, Telles Onetti L. Carcinomatosis peritoneal: conceptos y tratamiento con cirugía y quimioterapia hipertérmica intraperitoneal. [Internet]. Montevideo, Uruguay: Universidad de la República; 2014. [Citado: 2020, mayo] 110 p.

[7] Graniel-Palafox LE, Guerrero-Avendaño G. Vías de diseminación y sitios frecuentes de implantación metastásica en carcinomatosis peritoneal; hallazgos por tomografía. Anales de Radiología, Mexico. 2013 Jan 1;12(1).

[8] McMullen JR, Selleck M, Wall NR, Senthil M. Peritoneal carcinomatosis: limits of diagnosis and the case for liquid biopsy. Oncotarget. 2017 Jun 27;8(26):43481.

[9] Calderón Á, Cuéllar D. PET/CT 18F-FDG en carcinomatosis peritoneal: revisión de la fisiopatología y presentación de dos casos. Revista Colombiana de Cancerología. 2018 Jun;22(2):92-5.

[10] Franiel T, Diederichs G, Engelken F, Elgeti T, Rost J, Rogalla P. Multi-detector CT in peritoneal carcinomatosis: diagnostic role of thin slices and multiplanar reconstructions. Abdominal imaging. 2009 Jan 1;34(1):49-54.

[11] Coccolini F, Gheza F, Lotti M, Virzì S, Iusco D, Ghermandi C, Melotti R, Baiocchi G, Giulini SM, Ansaloni L, Catena F. Peritoneal carcinomatosis. World journal of gastroenterology: WJG. 2013 Nov 7;19(41):6979.

[12] Grotz TE, Fournier KF, Mansfield PF. Patient selection for cytoreductive surgery. Surgical Oncology Clinics. 2018 Jul 1;27(3):443-62.

[13] Baratti D, Kusamura S, Azmi N, Guaglio M, Montenovo M, Deraco M. Colorectal Peritoneal Metastases Treated by Perioperative Systemic Chemotherapy and Cytoreductive Surgery With or Without Mitomycin C-Based HIPEC: A Comparative Study Using the Peritoneal Surface Disease Severity Score (PSDSS). Annals of surgical oncology. 2020 Jan;27(1):98-106.

[14] Klaver YL, Chua TC, de Hingh IH, Morris DL. Outcomes of elderly patients undergoing cytoreductive surgery and perioperative intraperitoneal chemotherapy for colorectal cancer peritoneal carcinomatosis. Journal of surgical oncology. 2012 Feb 1;105(2):113-8.

[15] Razenberg LG, Van Gestel YR, Creemers GJ, Verwaal VJ, Lemmens VE, de Hingh IH. Trends in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of synchronous peritoneal carcinomatosis of colorectal origin in the Netherlands. European Journal of Surgical Oncology (EJSO). 2015 Apr 1;41(4):466-71.

[16] Esquivel J, Sticca R, Sugarbaker P, Levine E, Yan TD, Alexander R, Baratti D, Bartlett D, Barone R, Barrios P, Bieligk S. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Annals of surgical oncology. 2007 Jan 1;14(1):128-33.

[17] Elias D, Gilly F, Boutitie F, Quenet F, Bereder JM, Mansvelt B, Lorimier G, Dube P, Glehen O. Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric French study. J Clin Oncol. 2010 Jan 1;28(1):63-8.

[18] Kuijpers AM, Mirck B, Aalbers AG, Nienhuijs SW, de Hingh IH, Wiezer MJ, van Ramshorst B, van Ginkel RJ, Havenga K, Bremers AJ, de Wilt JH. Cytoreduction and HIPEC in the Netherlands: nationwide long-term outcome following the Dutch protocol. Annals of surgical oncology. 2013 Dec 1;20(13):4224-30.

[19] Flicek K, Ashfaq A, Johnson CD, Menias C, Bagaria S, Wasif N. Correlation of radiologic with surgical peritoneal cancer index scores in patients with pseudomyxoma peritonei and peritoneal carcinomatosis: how well can we predict resectability?. Journal of Gastrointestinal Surgery. 2016 Feb 1;20(2):307-12.

[20] Goéré D, Souadka A, Faron M, Cloutier AS, Viana B, Honoré C, Dumont F, Elias D. Extent of colorectal peritoneal carcinomatosis: attempt to define a threshold above which HIPEC does not offer survival benefit: a comparative study. Annals of surgical oncology. 2015 Sep 1;22(9):2958-64.

[21] López-Basave HN, Morales-Vásquez F, Luna Ortiz K, Méndez Herrera C, Ruiz-Molina JM. Citorreducción e HIPEC en carcinomatosis peritoneal. Experiencia del Instituto Nacional de Cancerología de México. Cirujano general. 2014;36(3):138-44.

[22] The Chicago Consensus on Peritoneal Surface Malignancies: standards. Annals of surgical oncology.2020;126(11), 2534-2540.

[23] Winer J, Zenati M, Ramalingam L, Jones H, Zureikat A, Holtzman M, Lee K, Ahrendt S, Pingpank J, Zeh HJ, Bartlett DL. Impact of aggressive histology and location of primary tumor on the efficacy of surgical therapy for peritoneal carcinomatosis of colorectal origin. Annals of surgical oncology. 2014 May 1;21(5):1456-62.

[24] Cashin PH, Graf W, Nygren P, Mahteme H. Comparison of prognostic scores for patients with colorectal cancer peritoneal metastases treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Annals of surgical oncology. 2013 Dec 1;20(13):4183-9.

[25] Chua TC, Morris DL, Esquivel J. Impact of the peritoneal surface disease severity score on survival in patients with colorectal cancer peritoneal carcinomatosis undergoing complete cytoreduction and hyperthermic intraperitoneal chemotherapy. Annals of Surgical Oncology. 2010 May 1;17(5):1330-6.

[26] Arjona-Sánchez A, Rodríguez-Ortiz L, Baratti D, Schneider MA, Gutiérrez-Calvo A, García-Fadrique A, Tuynman JB, Cascales-Campos PA, Martín VC, Morales R, Salti GI. RAS mutation decreases overall survival after optimal cytoreductive surgery and hyperthermic intraperitoneal chemotherapy of colorectal peritoneal metastasis: a modification proposal of the peritoneal surface disease severity score. Annals of surgical oncology. 2019 Aug 15;26(8):2595-604.

[27] Yong ZZ, Tan GH, Shannon N, Chia C, Teo MC. PROPS—A novel Pre-Operative Predictive Score for unresectability in patients with colorectal peritoneal metastases being considered for cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). World journal of surgical oncology. 2019 Dec 1;17(1):138.

[28] Cashin PH, Graf W, Nygren P, Mahteme H. Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis: prognosis and treatment of recurrences in a cohort study. European Journal of Surgical Oncology (EJSO). 2012 Jun 1;38(6):509-15.

[29] Nikolic S, Dzodic R, Zegarac M, Djurisic I, Gavrilovic D, Vojinovic V, Kocic M, Santrac N, Radlovic P, Radosavljevic D, Pupic G. Survival prognostic factors in patients with colorectal peritoneal carcinomatosis treated with cytoreductive surgery and intraoperative hyperthermic intraperitoneal chemotherapy: a single institution experience. J buon. 2014 Jan 1;19(1):66-74.

[30] Morales Soriano R. Estudio de los factores asociados con la morbi-mortalidad postoperatoria y la supervivencia tras citorreducción quirúrgica y quimioterapia intraperitoneal hipertérmica (HIPEC), en pacientes con carcinomatosis peritoneal por cáncer de colon. España. Universitat de les Illes Balears. 2019.

[31] Waite K, Youssef H. The role of neoadjuvant and adjuvant systemic chemotherapy with cytoreductive surgery and heated intraperitoneal chemotherapy for colorectal peritoneal metastases: a systematic review. Annals of surgical oncology. 2017 Mar 1;24(3):705-20.

[32] Huang C, Yang X, Yu Y, Wu H, Liu Y, Yonemura Y et al. Cytoreductive Surgery plus Hyperthermic Intraperitoneal Chemotherapy Improves Survival for Patients with Peritoneal Carcinomatosis from Colorectal Cancer: A Phase II Study from a Chinese Center. PLoS ONE. 2014;9(9)

[33] .

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