Abstract
PurposeThis nationwide study evaluated results of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis of colorectal origin in the Netherlands following a national protocol.MethodsIn a multi-institutional study prospective databases of patients with peritoneal carcinomatosis (PC) from colorectal cancer and pseudomyxoma peritonei (PMP) treated according to the Dutch HIPEC protocol, a uniform approach for the CRS and HIPEC treatment, were reviewed. Primary end point was overall survival and secondary end points were surgical outcome and progression-free survival. ResultsNine-hundred sixty patients were included; 660 patients (69 %) were affected by PC of colorectal carcinoma and the remaining suffered from PMP (31 %). In 767 procedures (80 %), macroscopic complete cytoreduction was achieved. Three-hundred and thirty one patients had grade III–V complications (34 %). Thirty-two patients died perioperatively (3 %). Median length of hospital stay was 16 days (range 0–166 days). Median follow-up period was 41 months (95 % confidence interval (CI), 36–46 months). Median progression-free survival was 15 months (95 % CI 13–17 months) for CRC patients and 53 months (95 % CI 40–66 months) for PMP patients. Overall median survival was 33 (95 % CI 28–38 months) months for CRC patients and 130 months (95 % CI 98–162 months) for PMP patients. Three- and five-year survival rates were 46 and 31 % respectively in case of CRC patients and 77 and 65 % respectively in case of PMP patients.ConclusionsThe results underline the safety and efficacy of cytoreduction and HIPEC for PC from CRC and PMP. It is assumed the uniform Dutch HIPEC protocol was beneficial.
Highlights
13–17 months) for CRC patients and 53 months for pseudomyxoma peritonei (PMP) patients
Clinicopathological characteristics are presented in Table 1; 960 patients were included in the study, and 660 patients were affected by PC of colorectal cancer (69 %) and the remaining suffered from PMP (31 %)
All centres in the Netherlands agreed on monitoring safety of the Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) and adopted the uniform Dutch HIPEC protocol
Summary
13–17 months) for CRC patients and 53 months (95 % CI 40–66 months) for PMP patients. Prospective study, published in the year 2000, median overall survival was 5.2 months for patients with colorectal cancer, and all patients with this condition had a fatal outcome.[5] Few studies have been performed to study the effect of chemotherapy on peritoneal metastasis of colorectal cancer.
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