Abstract
Background. Prolonged survival of patients affected by peritoneal metastasis (PM) of colorectal origin treated with complete cytoreduction followed by intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported. However, two-thirds of the patients after complete cytoreduction and perioperative chemotherapy (POC) develop recurrence. This study is to analyze the prognostic factors of PM from colorectal cancer following the treatment with cytoreductive surgery (CRS) + POC. Patients and Methods. During the last 8 years, 142 patients with PM of colorectal origin have been treated with CRS and perioperative chemotherapy. The surgical resections consisted of a combination of peritonectomy procedures. Results. Complete cytoreduction (CCR-0) was achieved at a higher rate in patients with peritoneal cancer index (PCI) score less than 10 (94.7%, 71/75) than those of PCI score above 11 (40.2%, 37/67). Regarding the PCI of small bowel (SB-PCI), 89 of 94 (91.5%) patients with ≤2 and 22 of 48 (45.8%) patients with SB-PCI ≥ 3 received CCR-0 resection (P < 0.001). Postoperative Grade 3 and Grade 4 complications occurred in 11 (7.7%) and 14 (9.9%). The overall operative mortality rate was 0.7% (1/142). Cox hazard model showed that CCR-0, SB-PCI ≤ 2, differentiated carcinoma, and PCI ≤ 10 were the independent favorite prognostic factors. Conclusions. Complete cytoreduction, PCI, SB-PCI threshold, and histologic type were the independent prognostic factors.
Highlights
In the past, peritoneal metastases (PM) from colorectal cancer have been considered a terminal stage of disease, and patients were offered the best supportive care and/or systemic chemotherapy with or without palliative surgery
In 2003, prolonged survival of patients affected by peritoneal metastasis (PM) of colorectal origin with complete cytoreduction followed by hyperthermic intraperitoneal chemotherapy (HIPEC) was reported in a prospective randomized phase III trial [3]
The recent therapeutic approach for colorectal cancer patients with PM is a comprehensive treatment consisting of cytoreductive surgery (CRS) plus peroperative intraperitoneal or systemic chemotherapy
Summary
Peritoneal metastases (PM) from colorectal cancer have been considered a terminal stage of disease, and patients were offered the best supportive care and/or systemic chemotherapy with or without palliative surgery. Over the past two decades, a new therapeutic alternative approach based on the combination of surgery with chemotherapy was developed as a treatment of PM. In this curative intent, the macroscopic disease was treated with cytoreductive surgery (CRS) followed by treating residual microscopic disease with an intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and/or early postoperative intraperitoneal chemotherapy (EPIC). Prolonged survival of patients affected by peritoneal metastasis (PM) of colorectal origin treated with complete cytoreduction followed by intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported. This study is to analyze the prognostic factors of PM from colorectal cancer following the treatment with cytoreductive surgery (CRS) + POC. PCI, SB-PCI threshold, and histologic type were the independent prognostic factors
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
