BACKGROUND: The presence of peritoneal carcinomatosis arising from colorectal cancer is associated with a poor prognosis. It was the purpose of this study to analyze morbidity, mortality, and survival after major cytoreductive surgery and intraperitoneal chemotherapy. MATERIALS AND METHODS: Thirty-two patients with peritoneal carcinomatosis were operated between April 2004 and June 2006 with the aim of complete macroscopical cytoreduction. All had a primary colorectal carcinoma. Surgery in these patients was followed by hyperthermic intraperitoneal chemotherapy (HIPEC) consisting of mitomycin C and doxorubicin. Data were analyzed retrospectively. RESULTS: Of all patients, 16 had appendix and 16 non-appendiceal colorectal carcinoma. A macroscopically complete cytoreduction was achieved in 24 patients by parietal and visceral peritonectomy procedures. All resections were combined with HIPEC. Overall morbidity was 34%. Most frequent surgical complications were intestinal obstruction (4/32), enteric fistula (2/32), pancreatitis (2/32), and bile leakage (2/32). One patient presented grade 4 renal toxicity. There was no hospital mortality. The median follow-up was 12 months. The 1-year overall survival rate is 96%. All patients after complete cytoreduction are still alive. CONCLUSIONS: Cytoreductive surgery combined with HIPEC is associated with an acceptable morbidity and low mortality. Complete cytoreduction may improve survival, particularly in well-selected patients having a low tumor volume and no extra-abdominal metastases.
BACKGROUND: The presence of peritoneal carcinomatosis arising from colorectal cancer is associated with a poor prognosis. It was the purpose of this study to analyze morbidity, mortality, and survival after major cytoreductive surgery and intraperitoneal chemotherapy. MATERIALS AND METHODS: Thirty-two patients with peritoneal carcinomatosis were operated between April 2004 and June 2006 with the aim of complete macroscopical cytoreduction. All had a primary colorectal carcinoma. Surgery in these patients was followed by hyperthermic intraperitoneal chemotherapy (HIPEC) consisting of mitomycin C and doxorubicin. Data were analyzed retrospectively. RESULTS: Of all patients, 16 had appendix and 16 non-appendiceal colorectal carcinoma. A macroscopically complete cytoreduction was achieved in 24 patients by parietal and visceral peritonectomy procedures. All resections were combined with HIPEC. Overall morbidity was 34%. Most frequent surgical complications were intestinal obstruction (4/32), enteric fistula (2/32), pancreatitis (2/32), and bile leakage (2/32). One patient presented grade 4 renal toxicity. There was no hospital mortality. The median follow-up was 12 months. The 1-year overall survival rate is 96%. All patients after complete cytoreduction are still alive. CONCLUSIONS: Cytoreductive surgery combined with HIPEC is associated with an acceptable morbidity and low mortality. Complete cytoreduction may improve survival, particularly in well-selected patients having a low tumor volume and no extra-abdominal metastases.
Authors: O Glehen; D Osinsky; E Cotte; F Kwiatkowski; G Freyer; S Isaac; V Trillet-Lenoir; A C Sayag-Beaujard; Y François; J Vignal; F N Gilly Journal: Ann Surg Oncol Date: 2003-10 Impact factor: 5.344
Authors: Vic J Verwaal; Serge van Ruth; Arjen Witkamp; Henk Boot; Gooike van Slooten; Frans A N Zoetmulder Journal: Ann Surg Oncol Date: 2004-12-27 Impact factor: 5.344
Authors: O Glehen; F Kwiatkowski; P H Sugarbaker; D Elias; E A Levine; M De Simone; R Barone; Y Yonemura; F Cavaliere; F Quenet; M Gutman; A A K Tentes; G Lorimier; J L Bernard; J M Bereder; J Porcheron; A Gomez-Portilla; P Shen; M Deraco; P Rat Journal: J Clin Oncol Date: 2004-08-15 Impact factor: 44.544
Authors: D Elias; T Matsuhisa; L Sideris; G Liberale; L Drouard-Troalen; B Raynard; M Pocard; J M Puizillou; V Billard; P Bourget; M Ducreux Journal: Ann Oncol Date: 2004-10 Impact factor: 32.976
Authors: Yvonne L B Klaver; Valery E P P Lemmens; Simon W Nienhuijs; Misha D P Luyer; Ignace H J T de Hingh Journal: World J Gastroenterol Date: 2012-10-21 Impact factor: 5.742
Authors: Christoph Kerscher; Michael Ried; Hans-Stefan Hofmann; Bernhard M Graf; York A Zausig Journal: J Cardiothorac Surg Date: 2014-07-25 Impact factor: 1.637