Cytoreductive surgery and hyperthermic intraperitenoal chemotherapy (HIPEC) for colorectal and appendiceal carcinomas with peritoneal carcinomatosis

J BUON. Nov-Dec 2017;22(6):1547-1553.

Abstract

Purpose: Cytoreductive surgery combined with intraperitoneal chemotherapy has been established as the standard treatment for selected patients with peritoneal malignancy. The purpose of the study was the presentation of the 10- year experience with cytoreductive surgery and intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colorectal and appendiceal origin.

Methods: Clinical and histopathological variables were retrospectively reviewed in a prospectively maintained database. All patients underwent cytoreductive surgery with the purpose of complete or near-complete cytoreduction. The variables were correlated to survival, and recurrences. Morbidity and hospital mortality were recorded.

Results: From 2006-2016 100 patients underwent cytoreductive surgery for colorectal and appendiceal carcinomas with peritoneal carcinomatosis. The hospital mortality and morbidity were 2% and 43% respectively. Completeness of cytoreduction (CC) 0 surgery was possible in 51% of the patients. The median and 10-year survival were 13 months and 23% respectively. The completeness of cytoreduction, performance status and the lymph node status were identified as prognostic indicators of survival. The recurrence rate was 55%. The completeness of cytoreduction, the lymph node status, and the use of postoperative adjuvant systemic chemotherapy were identified as prognostic variables of recurrence.

Conclusion: Nearly half of the patients with peritoneal carcinomatosis of colorectal and appendiceal origin may undergo complete cytoreduction and nearly half of them may enjoy long-term survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Appendiceal Neoplasms / complications
  • Appendiceal Neoplasms / drug therapy
  • Appendiceal Neoplasms / pathology
  • Appendiceal Neoplasms / surgery*
  • Colorectal Neoplasms / complications
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures*
  • Disease-Free Survival
  • Female
  • Humans
  • Hyperthermia, Induced / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Peritoneal Neoplasms / complications
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery*
  • Prognosis