Poor outcome after cytoreductive surgery and HIPEC for colorectal peritoneal carcinomatosis with signet ring cell histology

Abstract

Patients with SRCC and PC treated with CRS+HIPEC have a poor median survival only slightly reaching over 1 year. In the presence of other relative contraindications, SRCC histology should refrain a surgeon from performing CRS and HIPEC.

Major Postoperative Complications Are a Risk Factor for Impaired Survival after CRS/HIPEC

“…While no definite data regarding the specific outcome after CRS/HIPEC of those HG subgroups are available, it has been shown in prior studies that outcomes for intestinal and signet-ring adenocarcinomas are worse than for PMCA. [15][16][17] In contrast, in patients with LG appendicular neoplasms, we observed excellent long-term CSS and DFS. Although DPAM is normally not a rapidly progressing disease, patient morbidity still was high before the upcoming CRS/ HIPEC.…”

Signet ring colorectal carcinoma: Do we need to improve the treatment algorithm?

“…So authors concluded that CRS and HIPEC seems to be safe and beneficial in peritoneal metastases of colorectal origin[33]. But literature assessing benefit of HIPEC for SRCC is scarce and controversial with studies denying[34,35] and implying[36] benefit of HIPEC in this subgroup. But these reports are retrospective and are fraught with small sample sizes.…”

Primary signet ring cell carcinoma of the colon and rectum

“…A macroscopic complete resection was achieved in 97.2% of cases. Recurrences occur in 68.8% of SRCC, and the median survival was 14.1 months, whereas the median survival in the adenocarcinoma group was 35.1 months (P < 0.01)[44]. The investigators claim that SRCC histology should refrain a surgeon from performing cytoreductive surgery and HIPEC.…”