Abstract
BackgroundDiagnosis of peritoneal carcinomatosis (PC) may be missed by preoperative imaging. We are presenting our experience with incidentally detected PC of colorectal origin treated with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) at the same operation.MethodsBetween January 2010 and September 2016, 19 patients underwent CRS and IPC due to incidentally detected PC of colorectal origin. Data were analyzed from a prospectively collected database.ResultsThe median age was 59 (29–78). In three patients, PC was diagnosed during emergency surgery. The primary tumor was located in the rectum (three patients; one with recurrent disease), left colon (9 patients), and right colon (7 patients). All patients underwent CRS and IPC, and one patient operated laparoscopically. Median peritoneal cancer index (PCI) was 5 (range, 3–14), and complete cytoreduction (CC-0) was achieved in 14 patients. After CRS, 8 patients received early postoperative intraperitoneal chemotherapy (EPIC), 7 patients received hyperthermic intraperitoneal chemotherapy (HIPEC), and 4 patients received both HIPEC and EPIC. The median hospital stay was 9 (6–29) days. Postoperative complications occurred in 6 patients. There was no postoperative mortality. Median follow-up was 40.2 (12–94) months. Five-year overall survival was 63.2%. Estimated mean survival time is longer in patients who underwent complete cytoreduction compared to patients having CC-1 or CC-2 cytoreduction (87.7 vs. 20.3 months; p < 0.001).ConclusionCytoreductive surgery and IPC can be performed safely in patients with intraoperatively detected incidental PC of colorectal origin.
Highlights
Diagnosis of peritoneal carcinomatosis (PC) may be missed by preoperative imaging
We present our results of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) in patients who underwent
A recent meta-analysis confirmed the improvement of survival with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) in selected patients with peritoneal carcinomatosis from colorectal cancer [13]
Summary
Diagnosis of peritoneal carcinomatosis (PC) may be missed by preoperative imaging. We are presenting our experience with incidentally detected PC of colorectal origin treated with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) at the same operation. Peritoneal carcinomatosis (PC) from colorectal cancer (CRC) has a poor prognosis and often considered as a terminal condition. Overall survival with current systemic chemotherapy regimens with new chemotherapeutic and molecular targeting agents varies between 13 and 34 months [1,2,3]. Canda et al World Journal of Surgical Oncology (2018) 16:70 surgery for CRC with no preoperative suspicion of peritoneal metastasis
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