Cytoreductive Strategies in the Treatment of Carcinomatosis of Colorectal Origin: Results of a Transdisciplinary National Survey

Background: Many patients are not referred to centers specializing in the treatment of peritoneal malignancies. This survey evaluates Canadian physician attitudes toward the role of cytoreduction in treating colorectal carcinomatosis. Methods: A discrete-choice questionnaire containing a hypothetical scenario surveyed physician preferences for the management of colorectal carcinomatosis. Results: Three mail-outs yielded a 49% response rate (217 responses). For synchronous colorectal carcinomatosis, 28.6% favoured cytoreduction with or without HIPEC plus systemic chemotherapy, and 18.9% cytoreduction with HIPEC alone. For metachronous carcinomatosis, 27.4% favoured cytoreduction with or without HIPEC plus systemic chemotherapy, and 14.9% cytoreduction with HIPEC alone. For metachronous carcinomatosis with a single liver metastasis, 24.6% favoured cytoreduction with or without HIPEC plus systemic chemotherapy, and 4.6% cytoreduction with HIPEC alone. Conclusion: Most physicians do not favor cytoreduction in the treatment of colorectal carcinomatosis. Knowledge translation strategies are needed to improve awareness regarding its utility in specific clinical scenarios.