Effect and Safety of Intraoperative Intraperitoneal Chemotherapy on Patients Suffering From Colorectal Cancer.

Abstract

BackgroundColorectal cancer (CRC), the third most commonly diagnosed malignant neoplasm and the third most common cause of carcinoma-related mortality, continues to be a major international health problem. And approximately 33% of patients suffer from recurrence after radical surgery. Free malignant cells implanting in the peritoneum is generally accepted for present purposes. We did the study with the aim of evaluating the effects and safety of Intraoperative intraperitoneal chemotherapy (IOC) on patients suffering from colorectal cancer.MethodsIn total, 357 patients who went through colorectal radical surgery were considered eligible between September 23rd, 2017 to December 31st, 2018. 179 patients were treated with surgery alone, and 178 patients received surgery plus IOC. Clinical characteristics, operative findings, postoperative short-term outcomes and Disease- Free survival (DFS) were compared between the 2 groups in the selected population.ResultThe present research involves 357 patients (224 men and 133 women) who underwent surgery alone (n = 179) or surgery plus IOC (n = 178), with a mean (SD) age of 61.9 (10.4) years in the surgery alone group and 61.9 (9.1) in the surgery plus IOC group (P = .52). No significant differences were witnessed between the two groups in surgery-related information and postoperative complications. In patients with stage II colorectal cancer, the Disease- Free 1, 2and 3 years survival rates of surgery alone group were 98%, 91% and 86% respectively; and 96%, 94% and 81% respectively for surgery combined with IOC group (P = .82, Kaplan-Meier log-rank). In stage Ⅲ CRC patients, the survival rate analysis (Kaplan-Meier) showed a 82%, 68% and 61% Disease- Free survival of surgery alone group and a 94%, 85% and 82% of surgery plus IOC group after 1, 2 and 3 years, respectively (P = .002, Kaplan-Meier log rank).ConclusionsIn the present study, we have found that surgery plus IOC generated a favorable prognosis for stage Ⅲ CRC patients but not stage Ⅱ without any side-effects when the dosage of lobaplatin was 0.1 g/L. As a new, safe, and simple procedure, IOC therapy is easily performed anywhere and does not require any special devices or techniques. Thus, IOC is a promising and exciting therapeutic strategy for patients with CRC.