ASO Author Reflections: Tending Towards a Personalized Medicine for Colorectal Carcinomatosis by Adding the RAS Mutation Status in the Workup for CRS and HIPEC

Excerpt

The cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases (PM) has demonstrable survival benefits. However, the morbidity and the likelihood of an early relapse with consequent low survival rates have been high. Appropriate patient selection is a key factor and under constant inquiry. Until now, prognosis has only been assessed using clinical-pathologic factors. These predictors and the preoperative peritoneal cancer index (PCI) were combined into a clinical score called the Peritoneal Surface Disease Severity Score (PSDSS) described by Pelz et al.,1 in an attempt to offer greater potential long-term survival after CRS + HIPEC. This score was validated in a large, multicentre cohort and in a meta-analysis and has become the most recognized and widely used clinical score for predicting patient survival.2^,3 However, it does not reflect the biological behaviour of the tumour being a “corner stone” in a personalized oncologic management. …