Peritoneal Colorectal Carcinomatosis Treated with Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

Antonios-Apostolos K Tentes,Panagiotis Sarlis,Nikolaos Pallas,Anastasios Liberis,Odysseas Korakianitis,Christos Mavroudis,Athanasios Pagalos,Stephanos Popidis

doi:10.4236/ss.2012.32013

Abstract

Background-Aims: Peritoneal colorectal carcinomatosis is a potentially curative disease. The purpose of the study is the retrospective analysis of survival of the patients with peritoneal colorectal carcinomatosis that underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy and the identification of prognostic variables of the disease. Patients-Methods: Patients with primary or recurrent colorectal cancer and peritoneal carcinomatosis were included in the study. Clinical variables were correlated to survival, recurrence, hospital mortality, and morbidity. Results: From 2000-2010, 28 patients underwent 33 cytoreductive operations. The hospital mortality and morbidity rate was 9.1% and 45.5% respectively. The overall 5-year and median survival time was 29.2% and 19 months respectively. The extent of peritoneal carcinomatosis (p = 0.0003) and the completeness of cytoreduction (p = 0.0002) were related to survival. The completeness of cytoreduction (p = 0.003) was the single prognostic variable of survival. The recurrence rate was 42.4% and the use of systemic chemotherapy was identified as the single prognostic variable of recurrence (p = 0.047). Conclusions: Patients with limited extent of peritoneal colorectal carcinomatosis who undergo complete cytoreduction may be offered long-term survival.

Highlights

The liver and the peritoneal surfaces are the most frequent sites of metastatic disease of colorectal cancer in order of sequence [1]
The purpose of the study is the retrospective analysis of survival of the patients with peritoneal colorectal carcinomatosis that underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy and the identification of prognostic variables of the disease
The purpose of the study is the retrospective analysis of those patients with peritoneal carcinomatosis of colorectal cancer origin that underwent treatment with cytoreductive surgery and perioperative intraperitoneal chemotherapy and the identification of prognostic variables of the disease

Summary

Introduction

The liver and the peritoneal surfaces are the most frequent sites of metastatic disease of colorectal cancer in order of sequence [1]. The macroscopically visible tumor may be resected when maximal cytoreductive surgery with standard peritonectomy procedures is used. The purpose of the study is the retrospective analysis of survival of the patients with peritoneal colorectal carcinomatosis that underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy and the identification of prognostic variables of the disease. Clinical variables were correlated to survival, recurrence, hospital mortality, and morbidity. The extent of peritoneal carcinomatosis (p = 0.0003) and the completeness of cytoreduction (p = 0.0002) were related to survival. The completeness of cytoreduction (p = 0.003) was the single prognostic variable of survival. The recurrence rate was 42.4% and the use of systemic chemotherapy was identified as the single prognostic variable of recurrence (p = 0.047). Conclusions: Patients with limited extent of peritoneal colorectal carcinomatosis who undergo complete cytoreduction may be offered long-term survival

Objectives

Results

Conclusion