Population-based survival of patients with peritoneal carcinomatosis from colorectal origin in the era of increasing use of palliative chemotherapy

Abstract

BackgroundPalliative chemotherapy improves survival in patients with metastasised colorectal cancer. However, there is a lack of data regarding the effectiveness of modern chemotherapy in patients with isolated peritoneal carcinomatosis (PC). Patients and methodsAll patients with synchronous PC of colorectal origin diagnosed in the Eindhoven Cancer Registry registration area between 1995 and 2008 were included (N = 904). We assessed the use of chemotherapy and overall survival in three time periods related to the availability of different chemotherapy regimens. ResultsChemotherapy use gradually increased over time. Median survival (MS) for patients with PC without other metastases diagnosed in 1995–2000 was 35 weeks [95% confidence interval (CI) 24–43] and 34 weeks (25–54) in 2005–2008. MS in patients diagnosed with PC plus other metastases was 21 weeks (15–27) in 1995–2000 and 26 weeks (18–33) in 2005–2008. In multivariable regression analysis, use of chemotherapy had a beneficial influence on survival only in 2005–2008. In the first two periods, chemotherapy treatment did not decrease the risk for death. ConclusionDespite increasing usage of palliative chemotherapy and availability of new agents, population-based survival of patients with PC did not improve until very recently. Response to palliative chemotherapy in PC should be evaluated separately from haematogenous metastases.