Paramythiotis D, Tsavdaris D, Geropoulos G, Sacchet DA, Psarras K. Management of peritoneal metastases from colorectal cancer and small bowel adenocarcinoma in patients with inflammatory bowel disease. World J Gastrointest Oncol 2025; 17(11): 110486 [DOI: 10.4251/wjgo.v17.i11.110486]
Corresponding Author of This Article
Daniel Paramythiotis, MD, PhD, Full Professor, First Department of Propaedeutic Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Street Kyriakidi 1, Thessaloniki 54636, Greece. danosprx@auth.gr
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 15, 2025 (publication date) through Nov 13, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Oncology
ISSN
1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Paramythiotis D, Tsavdaris D, Geropoulos G, Sacchet DA, Psarras K. Management of peritoneal metastases from colorectal cancer and small bowel adenocarcinoma in patients with inflammatory bowel disease. World J Gastrointest Oncol 2025; 17(11): 110486 [DOI: 10.4251/wjgo.v17.i11.110486]
Daniel Paramythiotis, Dimitrios Tsavdaris, Dominick Alessandro Sacchet, First Department of Propaedeutic Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
Georgios Geropoulos, Kyriakos Psarras, Third Department of Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
Author contributions: Paramythiotis D conceptualized the review topic and designed the structure of the manuscript; Tsavdaris D, Geropoulos G, and Sacchet DA conducted the literature search, analyzed the available data, and drafted the initial manuscript; Psarras K provided critical revisions, contributed to the clinical and methodological interpretation, and ensured accuracy and coherence of the final content; All authors reviewed and approved the final version of the manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Daniel Paramythiotis, MD, PhD, Full Professor, First Department of Propaedeutic Surgery, University General Hospital of Thessaloniki AHEPA, Aristotle University of Thessaloniki, Street Kyriakidi 1, Thessaloniki 54636, Greece. danosprx@auth.gr
Received: June 9, 2025 Revised: June 26, 2025 Accepted: September 19, 2025 Published online: November 15, 2025 Processing time: 160 Days and 6.7 Hours
Abstract
Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer, which may ultimately result in peritoneal metastases (PM). PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD. This minireview compiled existing evidence on management approaches to PM in patients with IBD, including surgical procedures, systemic treatment, and novel therapies. A literature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer. Literature specific to PM in IBD is sparse, comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with and without IBD. These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD. However, median overall survival (approximately 19.6-24.0 months) and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD. Although CRS/HIPEC can be performed safely in selected patients with IBD and PM, long-term oncologic outcomes appear inferior compared to populations without IBD, likely reflecting later-stage presentation, distinct tumor biology, and IBD-related factors.
Core Tip: Peritoneal metastases in patients with inflammatory bowel disease (IBD) represent a rare but clinically significant complication of IBD-associated colorectal and small bowel cancers. This minireview highlighted the unique challenges in diagnosis, treatment, and prognosis for this population, emphasizing that while cytoreductive surgery with hyperthermic intraperitoneal chemotherapy is feasible, long-term oncological outcomes remain inferior to patients without IBD. This minireview underscored the urgent need for IBD-specific research, refined surveillance strategies, and personalized therapeutic approaches.
