Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with liver involvement

Berger, Yaniv; Aycart, Samantha N.; Tabrizian, Parissa; Agmon, Yahel; Mandeli, John; Heskel, Marina; Hiotis, Spiros P.; Sarpel, Umut; Labow, Daniel M.

doi:10.1002/jso.24153

Cited by 22 publications

(19 citation statements)

References 21 publications

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“…As CRS with HIPEC has an overall morbidity rate of 23–45% and mortality rate of 0–12% in CRC patients with peritoneal metastasis only, the addition of concurrent liver resection does not seem to reduce safety [25]. Berger et al suggested that perioperative complication rate, length of hospital stay, and intraoperative blood transfusion were related to more extensive cytoreduction, rather than liver surgery itself [26]. In our study, only one patient died of intestinal anastomotic leakage; she had three anastomoses, which was relatively higher compared to other patients, without stoma diversion.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer

et al. 2019

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BackgroundThis study aimed to evaluate the clinical outcomes of concurrent liver resection with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in colorectal cancer patients with synchronous liver and peritoneal metastases.MethodsPatients with colorectal liver and peritoneal metastasis who underwent complete cytoreduction and hyperthermic intraperitoneal chemotherapy with concurrent liver surgery between September 2014 and July 2018 were included. Perioperative outcomes, overall survival, and progression-free survival were analyzed retrospectively.ResultsIn total, 22 patients were included. The median peritoneal cancer index was 13 (range, 0–26), and the median number of liver metastases was 3 (range, 1–13). The mean total operative time was 11.4 ± 2.6 h. Minor postoperative complications (Clavien-Dindo grade I–II) were reported in 10 patients (45.5%), and major postoperative complications (grade III–V) were reported in five patients (22.7%), including one mortality patient. The median overall survival since diagnosis with metastasis was 27.4 months. The median overall survival since surgical intervention and the progression-free survival were 16.7 months and 7.1 months, respectively.ConclusionsThis short-term follow-up study showed that, in an experienced center, combined resection with hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases was feasible and safe with acceptable oncologic outcomes.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer

et al. 2019

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“…In total, 3137 patients participated in 2 case-control studies, 11 prospective studies, and 7 retrospective cohort studies. [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] No randomized studies were identified. Although the search and selection process was designed to include various oligometastatic sites, the studies that met the criteria for inclusion all presented liver metastases.…”

Section: Study Characteristicsmentioning

confidence: 99%

Outcomes of Combined Peritoneal and Local Treatment for Patients with Peritoneal and Limited Liver Metastases of Colorectal Origin: A Systematic Review and Meta-Analysis

et al. 2021

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Background Almost half of all colorectal cancer (CRC) patients will experience metastases at some point, and in the majority of cases, multiple organs will be involved. If the peritoneum is involved in addition to the liver, the current guideline-driven treatment options are limited. The reported overall survival ranges from 6 to 13 months for the current standard of care (systemic treatment). This study aimed to evaluate morbidity and clinical long-term outcomes from a combined local treatment of hepatic metastases with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) used to treat peritoneal metastases. Methods A systematic search was performed in PubMed, Embase.com, Web of Science, and Cochrane. Studies evaluating the clinicopathologic data of patients who had both peritoneal and hepatic metastases treated with CRS-HIPEC were included provided sufficient data on the primary outcomes (overall and disease-free survival) were presented. The quality of included studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Results Patients treated for peritoneal and liver metastases (PMLM group) had a pooled mean survival of 26.4 months (95% confidence interval [CI] 22.4–30.4 months), with a 3-year survival rate of 34% (95% CI 26.7–42.0%) and a 5-year survival rate of 25% (95% CI 17.3–33.8%). Surgical complications occurred more frequently for these patients than for those with peritoneal metastasis only (40% vs 22%; p = 0.0014), but the mortality and reoperation rates did not differ significantly. Conclusion This systematic review showed that CRS and HIPEC combined with local treatment of limited liver metastasis for selected patients is feasible, although with increased morbidity and an association with a long-term survival rate of 25%, which is unlikely to be achievable with systemic treatment only.

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“…These data are reassuring given concomitant HM, in most cases, represent both systemic and loco‐regional disease. Some series have reported that synchronous HM compromise outcomes . Randle and colleagues reported a median OS of 21.2 months for patients with HM compared to 33.6 months for those without HM ( P = 0.03).…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have demonstrated that concomitant HR increases peri‐operative morbidity and compromises survival outcomes . Others have shown that concomitant HR is safe and effective .…”

Section: Introductionmentioning

confidence: 99%

Limited synchronous hepatic resection does not compromise peri‐operative outcomes or survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Saxena

Valle

Morris

2017

Journal of Surgical Oncology

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with liver involvement

Cited by 22 publications

References 21 publications

Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer

Clinical outcomes of complete cytoreduction with concurrent liver resection followed by hyperthermic intraperitoneal chemotherapy for synchronous peritoneal and liver metastatic colorectal cancer

Outcomes of Combined Peritoneal and Local Treatment for Patients with Peritoneal and Limited Liver Metastases of Colorectal Origin: A Systematic Review and Meta-Analysis

Limited synchronous hepatic resection does not compromise peri‐operative outcomes or survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

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