Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal carcinomatosis of colorectal cancer: 2-year follow-up results at a single institution in Korea

Abstract

PurposeThe purpose of this study was to examine 2-year follow-up results of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) for peritoneal carcinomatosis (PC) of colorectal cancer.MethodsWe performed 54 cases of CRS and IPC in 53 patients with PC of colorectal cancer from December 2011 to December 2013. We collected data prospectively and analyzed the grade of PC, morbidity and mortality, and short-term follow-up (median, 10 months; range, 2–47 months) results.ResultsMean peritoneal cancer index (PCI) was 15 (range, 1–35), and complete cytoreduction was possible in 35 patients (64.8%). Complications occurred in 25 patients (46.3%) and mortality occurred in 4 patients (7.4%). Excluding the 4 mortalities, 17 patients out of 49 patients (31.5%) were alive at the time of the last follow-up and the overall median survival was 10.3 months. Patients with complete cytoreduction had a median survival of 22.6 months, which was significantly longer than the median survival of 3.5 months for patients without complete cytoreduction (P < 0.001). PCI grade, CCR grade, cell type, and postoperative chemotherapy were significant prognostic factors by univariate analysis. Positive independent prognostic factors by multivariate analysis included PCI grade and postoperative chemotherapy.ConclusionCRS and IPC increased the survival of patients with low PCI and postoperative systemic chemotherapy was mandatory. However, this combined therapeutic approach showed high rate of complications and mortality. Therefore, this aggressive treatment should be performed in only selected patients by considering the general condition of the patient and the extent of PC.

Is Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy a Safe and Effective Procedure for Treating Patients With a Peritoneal Surface Malignancy?

“…Kim et al [2] reported 30-day rates of postoperative morbidity and mortality of 30.4% and 0%, respectively, which are comparable to the results reported in Newton et al [1] and Jo et al [3]. The occurrence of major complications was found to be associated with the number of organ resections (more than 3), the duration of surgery (≥630 minutes) and the amount of blood loss (≥600 mL) during surgery.…”

Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy as Treatment Options for Peritoneal Metastasis of Advanced Gastric Cancer

“…HIPEC and early postoperative intraperitoneal chemotherapy (EPIC) were performed in accordance with the aforementioned standard procedure followed at our institution [ 9 ]. HIPEC was performed using the closed method with a Belmont hyperthermic pump (Belmont Instrument Corp., Billerica, MA, USA).…”

“…At our institution, CRS and intraperitoneal chemotherapy have been performed since the early 2000 in patients with colorectal cancer, and we reported the short-term outcomes of these treatments in 2016 [ 9 ]. We continued to improve the techniques in CRS and HIPEC.…”

Synchronized Bilateral Giant Krukenberg Tumor Originating from the Colon

“…It is more inclined local recurrence and prognosis is extremely poor with a mean life expectancy of only 6 months. 5 As shown in previous publications, patients in the study of Xu et al 1 were diagnosed with KTs at a median age of 49 years. Since our patient is 18 years old, a genetic disorder like Lynch syndrome has come to mind too, but there was no cancer story in patient's father and uncle.…”

“…5 Synchronous PC is found in 10%-15% of colorectal cancer patients such as in our patient. It is more inclined local recurrence and prognosis is extremely poor with a mean life expectancy of only 6 months.…”