Unresectable Peritoneal Carcinomatosis From Colorectal Cancer: A Single Center Experience

J Surg Oncol. 2011 Sep 1;104(3):269-73. doi: 10.1002/jso.21937. Epub 2011 Apr 4.

Abstract

Background and objectives: For unresectable peritoneal carcinomatosis (PC) median overall survival (OS) is 5-6 months. This article analyzes patients with PC from colorectal cancer (CRC) uneligible for debulking and hyperthermic intra-peritoneal chemotherapy, describing patient- and tumor-related factors possibly affecting survival.

Patients and methods: From 2005 to 2009, 43 patients presented with unresectable PC from CRC: male/female ratio was 29/14, median age was 57.1 years (range 34.8-76.8). "Unresectability" was defined as: six to seven abdominal regions affected by PC, involvement of mesentery or small bowel in the PC, presence of liver metastases, retroperitoneal lymph nodes, vascular invasion, and/or neural invasion.

Results: Median time interval between diagnosis of the primary tumor and diagnosis of PC was 7.2 months (range 0.0-102.3). Primary tumors were right-sided in >50% and had been previously resected in >58%, 74.4% of PC occurred synchronously. Ascites was present at primary diagnosis in 37.2%. In 70% of cases, six to seven abdominal regions were affected and in 58.1% PC involved small bowel/mesentery. Systemic disease was present in 16.3%. In 18.6% of patients, a palliative diversion or ostomy was constructed. Median OS was 6.3 months (range 0.4-33.1). Thirty-one patients (72.1%) received palliative chemotherapy. Median OS was 9.3 months (range 0.9-33.1) with versus 3.1 months (range 0.4-6.5) without chemotherapy (P = 0.000), with less favorable patient and tumor characteristics in the latter group. No other factors clearly influenced OS.

Conclusion: Palliative chemotherapy results in better OS, but this is probably attributable to factors influencing the patient's general condition.

Publication types

  • Clinical Trial

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Bevacizumab
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Carcinoma / drug therapy*
  • Carcinoma / secondary
  • Carcinoma / surgery
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Irinotecan
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery
  • Male
  • Middle Aged
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / secondary
  • Peritoneal Neoplasms / surgery
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Organoplatinum Compounds
  • Oxaliplatin
  • Bevacizumab
  • Irinotecan
  • Camptothecin