P-0183 Outcomes of Patients With Colorectal Cancer With Peritoneal Carcinomatosis Who Underwent Cytoreductive Surgery and Intraperitoneal Chemotherpy Versus Palliative Chemotherapy

Abstract

ABSTRACT Introduction Patients with advanced colorectal cancer and peritoneal carcinomatosis (PC) have a poor prognosis with median survival ranging from 6 to 8 months. Novel treatment strategies have emerged combining cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with improved outcomes. The aim of this retrospective analysis is to evaluate the outcomes in patients with advanced colorectal cancer with PC who had undergone CRS with peritonectomy and HIPEC versus those who underwent resection of primary and palliative chemotherapy. Methods From our institutional database, we identified 43 patients with colorectal cancer with metastasis isolated to the peritoneum. 21 patients received local resection of the primary colonic tumour and chemotherapy. 22 patients received CRS with peritonectomy and HIPEC. Demographic data, treatment and survival data were collated and analysed. Results All patients had good performance status with ECOG less than or equal to 1. The median follow up of all patients still alive was 20.7 months. The median time from detection of peritoneal metastasis to peritonectomy was 4.6 months. The progression free survival for patients who underwent peritonectomy and HIPEC was 9.6 months (95% CI 6.6-12.6). From time of detection of peritoneal metastasis, overall survival for patients who underwent peritonectomy versus those who did not was 47 months and 18 months respectively (HR 0.18; 95% CI: 0.05-0.67, p =0.01). However there is substantial selection bias with the peritonectomy group comprising younger patients with mean age of 49 years old versus 59 years old in the non - peritonectomy group (P=0.02). All the patients who did not undergo peritonectomy were stage IV at diagnosis whereas in the group who underwent peritonectomy, only 45.4% were stage IV at diagnosis. Conclusion In well selected group of patients with advanced colorectal cancer and peritoneal carcinomatosis, good long term survival outcomes with cytoreductive surgery with peritonectomy and HIPEC can be achieved.