Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer: a 13 years-retrospective monocentric study
|Journal||Volume 85 - 2022|
|Issue||Fasc.4 - Original articles|
|Author(s)||M. Livin 1, D. Leonard 1, R. Bachmann 1, C. Remue 1, S. Barbois 2, E. Cotte 3, M. Van Den Eynde 4 5, A. De Cuyper 4, I. Sinapi 4, A. Van Maanen 6, A. Kartheuser 1|
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(1) Colorectal Surgery Unit, Department of Abdominal Surgery and Transplantation, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
(2) Department of General, Digestive, Oncological, Bariatric and Metabolic Surgery, Hôpitaux Universitaires Paris Seine-Saint-Denis, France
(3) Department of Digestive, Thoracic and Endocrine Surgery, Centre Hospitalier Universitaires Lyon-Sud, France
(4) Department of Medical Oncology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
(5) Department of Gastroenterology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
(6) Statistical Support Unit, Institut Roi Albert II Cancer Center, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
Background and study aim: Over the last 20 years, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has progressively become a therapeutic option for peritoneal carcinomatosis thanks to its favourable oncologic results. The aim of this study is to analyse the overall survival and recurrence-free survival, after complete CRS and closed abdomen technique HIPEC for peritoneal carcinomatosis from colorectal cancer.
Patients and methods: This retrospective study collected the data from all patients who underwent a CRS with HIPEC for colorectal cancer at “Cliniques universitaires Saint Luc” from October 2007 to December 2020. Ninety-nine patients were included.
Results: The median follow-up was 34 months. Post-operative mortality and Clavien-Dindo grade III/IV morbidity rates were 2.0% and 28.3%. The overall 2-year and 5-year survival rates were 80.1% and 54.4%. Using the multivariate analysis, age at surgery, liver metastases and PCI score >13 showed a statistically significant negative impact on overall survival. The 2-year and 5-year recurrence-free survival rates were 33.9% and 22%. Using the multivariate analysis, it was found that liver metastases, the extent of carcinomatosis with PCI>7 have a statistically significant negative impact on recurrence-free survival.
Conclusions: Despite a high recurrence rate, CRS followed by HIPEC to treat peritoneal carcinomatosis from colorectal origin offer encouraging oncologic results with a satisfying survival rate. When PCI>13, CRS and HIPEC does not seem to offer any survival benefit and to efficiently limit recurrence, our data are in favor of a maximum PCI of 7.
Keywords: cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, peritoneal carcinomatosis.
© Acta Gastro-Enterologica Belgica.