Clinical and Molecular Features in Patients Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinosis from Colorectal Cancer

J Gastrointest Surg. 2021 Oct;25(10):2649-2659. doi: 10.1007/s11605-021-05073-3. Epub 2021 Jul 9.

Abstract

Purpose: Careful patient selection plays a crucial role in avoiding overtreatment and further increases survival rates in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer (CRC) with peritoneal metastases (PM).

Methods: The clinical and molecular factors influencing survival in patients who had undergone CRS with HIPEC between January 2015 and December 2018 were analyzed.

Results: Sixty-six patients underwent CRS with HIPEC during the study period. The median overall survival (OS) was 36 months, with a 3-year OS of 43%. Multivariate analysis revealed increased PCI (HR: 1.21; 95% CI: 1.02-1.41; p = 0.020), right-sided primary tumor (HR: 3.01; 95% CI: 1.27-7.13; p = 0.017), and BRAF V600E mutation (HR: 4.55; 95% CI: 1.21-17.21; p = 0.025) as independent predictors for worse OS.

Conclusion: In addition to confirming the prognostic role of PCI, our study extends the role of BRAF mutation and right primary tumor location as markers for worse prognosis.

Keywords: BRAF; Colorectal cancer; Cytoreductive surgery (CRS); Hyperthermic intraperitoneal chemotherapy (HIPEC); Peritoneal metastasis.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Colorectal Neoplasms* / drug therapy
  • Combined Modality Therapy
  • Cytoreduction Surgical Procedures
  • Humans
  • Hyperthermia, Induced*
  • Hyperthermic Intraperitoneal Chemotherapy
  • Percutaneous Coronary Intervention*
  • Peritoneal Neoplasms* / drug therapy
  • Prognosis
  • Retrospective Studies
  • Survival Rate