Impact of multimodal treatment on patient outcomes and prognosis in colorectal peritoneal metastases

The present thesis focussed on patients with colorectal peritoneal metastases: a disease which is known for its poor survival, even though treatment strategies have improved over the past years. Furthermore, population-based studies in this thesis showed that the incidence of colorectal peritoneal metastases is increasing. To further improve survival in this growing group of patients, the CAIRO6 study was initiated, in which the value of perioperative (before and after surgery) chemotherapy is being investigated. Safety and feasibility results of this study are depicted in this thesis. Also, patient-reported outcomes from this trial were investigated. Intra-operative treatment strategies with regard to the choice of HIPEC chemotherapeutic regimen, as well as adjuvant systemic chemotherapy after surgery, both investigated in nationwide cohorts are elaborated in this thesis. In summary, this thesis highlighted the relevance of this disease among Dutch colorectal cancer patients, elaborated new treatment options to further improve patient survival and elicted the impact of this disease on patients’ quality of life in patient-reported outcome studies. The present thesis will contribute to better knowledge, insight, treatment and patient education for physicians treating, and patients suffering from colorectal peritoneal metastases.