Adjuvant Perioperative Intraperitoneal Chemotherapy in Locally Advanced Colorectal Carcinoma: Preliminary Results

Abstract

Background and Aims. Intraperitoneal chemotherapy is a basic tool in the treatment of peritoneal malignancy. The purpose of the study is to investigate the effect of adjuvant perioperative intraperitoneal chemotherapy in the treatment of locally advanced colorectal cancer. Patients and Methods. Patients with T3 and T4 colorectal carcinomas that underwent R0 resection received either hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC group = 40 patients) or early postoperative intraperitoneal chemotherapy (EPIC group = 67 patients). The survival, the recurrences and the sites of recurrence were assessed. Results. The 3-year survival rate for HIPEC group was 100% and for EPIC group 69% (P = .011). Nodal infiltration was found to be the single prognostic indicator of survival. The incidence of recurrence in EPIC group was higher than in HIPEC group (P = .009). The independent indicators of recurrence were the use of HIPEC and the degree of differentiation (P < .05). Conclusions. Intraperitoneal chemotherapy, particularly HIPEC, as an adjuvant in locally advanced colorectal carcinomas appears to improve survival and decrease the incidence of recurrence.

Aggressive locoregional management of recurrent peritoneal sarcomatosis

“…This study did not show a local or distant recurrence‐free or overall survival advantage with EPIC with CRS versus CRS alone. However, the lack of hyperthermia and uneven drug distribution are potential disadvantages of EPIC versus HIPEC 14. No randomized controlled trial has been completed comparing CRS with HIPEC to CRS alone for sarcomatosis.…”

Hyperthermic intraperitoneal chemotherapy with mitomycin C and 5-fluorouracil in patients at high risk of peritoneal metastasis from colorectal cancer: A preliminary clinical study

“…Although the size of the patient sample was limited, several randomized studies suggested that adjuvant HIPEC may significantly improve survival and reduce the incidence rate of PC in patients with gastric cancer and CRC (22)(23)(24)(25). A positive peritoneal lavage following macroscopic curative surgery in patients with CRC appears to be associated with decreased survival and increased recurrence of PM (7)(8)(9) and HIPEC appears to be a suitable treatment for patients at high risk of PM.…”

Regimens of Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis from Colorectal Cancer

“…Tentes et al reported that patients receiving HIPEC with MMC or oxaliplatin had a better prognosis than those receiving EPIC with 5-FU (85). Based on these results, a randomized control trial for HIPEC with oxaliplatin has been initiated for patients with T4 or intra-abdominally perforated colon cancer without distant metastases (86).…”