Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges
The presence of peritoneal metastases (PM) in patients with colorectal cancer (CRC) is associated with an extremely poor prognosis. The diagnosis of PM is challenging, resulting in an underestimation of their true incidence. While surgery can be curative in a small percentage of patients, effective...
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2021-03-01
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doaj-bd40f6d4eaac4f10bb6409759d8fd50b2021-03-16T06:10:53ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-03-011110.3389/fonc.2021.650098650098Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the ChallengesOnno Kranenburg0Onno Kranenburg1Kurt van der Speeten2Ignace de Hingh3Department of Surgical Oncology, University Medical Center Utrecht, Utrecht, NetherlandsUtrecht platform for Organoid Technology, Utrecht University, Utrecht, NetherlandsDepartment of Surgical Oncology, Faculty of Medicine, Biomedical Research Institute (BIOMED) Research Institute, Hospital Oost-Limburg, Belgium and University Hasselt, Diepenbeek, BelgiumDepartment of Surgery, Research School for Oncology and Developmental Biology, Catharina Hospital Eindhoven, The Netherlands and Maastricht University, Maastricht, NetherlandsThe presence of peritoneal metastases (PM) in patients with colorectal cancer (CRC) is associated with an extremely poor prognosis. The diagnosis of PM is challenging, resulting in an underestimation of their true incidence. While surgery can be curative in a small percentage of patients, effective treatment for non-operable PM is lacking, and clinical and pre-clinical studies are relatively sparse. Here we have defined the major clinical challenges in the areas of risk assessment, detection, and treatment. Recent developments in the field include the application of organoid technology, which has generated highly relevant pre-clinical PM models, the application of diffusion-weighted MRI, which has greatly improved PM detection, and the design of small clinical proof-of-concept studies, which allows the efficient testing of new treatment strategies. Together, these developments set the stage for starting to address the clinical challenges. To help structure these efforts, a translational research framework is presented, in which clinical trial design is based on the insight gained from direct tissue analyses and pre-clinical (organoid) models derived from CRC patients with PM. This feed-forward approach, in which a thorough understanding of the disease drives innovation in its clinical management, has the potential to improve outcome in the years to come.https://www.frontiersin.org/articles/10.3389/fonc.2021.650098/fullcolorectalCMS4peritonealimagingorganoid |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Onno Kranenburg Onno Kranenburg Kurt van der Speeten Ignace de Hingh |
spellingShingle |
Onno Kranenburg Onno Kranenburg Kurt van der Speeten Ignace de Hingh Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges Frontiers in Oncology colorectal CMS4 peritoneal imaging organoid |
author_facet |
Onno Kranenburg Onno Kranenburg Kurt van der Speeten Ignace de Hingh |
author_sort |
Onno Kranenburg |
title |
Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges |
title_short |
Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges |
title_full |
Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges |
title_fullStr |
Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges |
title_full_unstemmed |
Peritoneal Metastases From Colorectal Cancer: Defining and Addressing the Challenges |
title_sort |
peritoneal metastases from colorectal cancer: defining and addressing the challenges |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2021-03-01 |
description |
The presence of peritoneal metastases (PM) in patients with colorectal cancer (CRC) is associated with an extremely poor prognosis. The diagnosis of PM is challenging, resulting in an underestimation of their true incidence. While surgery can be curative in a small percentage of patients, effective treatment for non-operable PM is lacking, and clinical and pre-clinical studies are relatively sparse. Here we have defined the major clinical challenges in the areas of risk assessment, detection, and treatment. Recent developments in the field include the application of organoid technology, which has generated highly relevant pre-clinical PM models, the application of diffusion-weighted MRI, which has greatly improved PM detection, and the design of small clinical proof-of-concept studies, which allows the efficient testing of new treatment strategies. Together, these developments set the stage for starting to address the clinical challenges. To help structure these efforts, a translational research framework is presented, in which clinical trial design is based on the insight gained from direct tissue analyses and pre-clinical (organoid) models derived from CRC patients with PM. This feed-forward approach, in which a thorough understanding of the disease drives innovation in its clinical management, has the potential to improve outcome in the years to come. |
topic |
colorectal CMS4 peritoneal imaging organoid |
url |
https://www.frontiersin.org/articles/10.3389/fonc.2021.650098/full |
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