Cytoreductive surgery combined with hyperthermic intraperitoneal intraoperative chemotherapy for peritoneal carcinomatosis arising from colon adenocarcinoma

Ann Surg Oncol. 2003 Jun;10(5):508-13. doi: 10.1245/aso.2003.08.004.


Background: Hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) has been recently proposed to treat peritoneal carcinomatosis arising from colon adenocarcinoma, which is usually regarded as a lethal clinical entity. The purpose of this study was to evaluate the clinical outcome of this combined treatment.

Methods: A retrospective study of 46 patients treated for peritoneal carcinomatosis from colon adenocarcinoma was performed. Thirty-four patients were treated with complete cytoreductive surgery immediately followed by intraoperative HIIC with mitomycin C and cisplatin. The clinical outcome of these 34 patients was analyzed; the median follow-up period was 14.5 months.

Results: No postoperative deaths were reported. The postoperative morbidity rate was 35%. No severe locoregional or systemic toxicity was observed. The 2-year overall survival was 31%, and the median survival time and the median time to local disease progression were 18 and 13 months, respectively. Survival and local disease control in patients with well- and moderately differentiated colon adenocarcinoma were significantly better than in those with poorly differentiated tumors.

Conclusions: Considering the dismal prognosis of this condition, HIIC seems to achieve encouraging results in a selected group of patients affected with resectable peritoneal carcinomatosis arising from colon adenocarcinoma. These findings support the conduction of formal phase III randomized trials.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma / secondary*
  • Cell Differentiation
  • Cisplatin / administration & dosage
  • Colonic Neoplasms / pathology*
  • Combined Modality Therapy
  • Disease Progression
  • Female
  • Humans
  • Hyperthermia, Induced*
  • Infusions, Parenteral
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / secondary*
  • Peritoneal Neoplasms / surgery
  • Prognosis
  • Survival Analysis
  • Treatment Outcome


  • Mitomycin
  • Cisplatin