BACKGROUND AND OBJECTIVES: CytoReductive Surgery (CRS) combined with Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) has an established role in the treatment of peritoneally metastasized colorectal cancer. The aim of the study was to describe the recurrence patterns and to evaluate treatment options and related survival. METHODS: Patients treated with CRS + HIPEC in two tertiary referral centers between April 2005 and March 2013 were analyzed retrospectively. The prognostic value of several parameters was calculated using Cox Regression. RESULTS: One hundred thirty two of 287 patients (46%) with peritoneal carcinomatosis treated with complete CRS and HIPEC were diagnosed with recurrent disease, after a median disease-free interval of 11.4 months. Recurrence were locoregional (43%), distant metastases (26%) or both (31%). Thirty-two of the 132 patients with recurrences (24%) were treated surgically with curative intent, which extended the median survival from 12 months to 43 months, compared to palliative treatment (best supportive care or chemotherapy; P < 0.001). Initial nodal status (P = 0.01) and the number of affected regions at initial CRS (P = 0.02) were significantly correlated to survival after disease recurrence. CONCLUSION: Disease recurrence after CRS and HIPEC is common; in selected patients, an aggressive surgical approach may be beneficial and extend survival.
BACKGROUND AND OBJECTIVES: CytoReductive Surgery (CRS) combined with Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) has an established role in the treatment of peritoneally metastasized colorectal cancer. The aim of the study was to describe the recurrence patterns and to evaluate treatment options and related survival. METHODS:Patients treated with CRS + HIPEC in two tertiary referral centers between April 2005 and March 2013 were analyzed retrospectively. The prognostic value of several parameters was calculated using Cox Regression. RESULTS: One hundred thirty two of 287 patients (46%) with peritoneal carcinomatosis treated with complete CRS and HIPEC were diagnosed with recurrent disease, after a median disease-free interval of 11.4 months. Recurrence were locoregional (43%), distant metastases (26%) or both (31%). Thirty-two of the 132 patients with recurrences (24%) were treated surgically with curative intent, which extended the median survival from 12 months to 43 months, compared to palliative treatment (best supportive care or chemotherapy; P < 0.001). Initial nodal status (P = 0.01) and the number of affected regions at initial CRS (P = 0.02) were significantly correlated to survival after disease recurrence. CONCLUSION: Disease recurrence after CRS and HIPEC is common; in selected patients, an aggressive surgical approach may be beneficial and extend survival.
Authors: Adriana C Gamboa; Mohammad Y Zaidi; Rachel M Lee; Shelby Speegle; Jeffrey M Switchenko; Joseph Lipscomb; Jordan M Cloyd; Ahmed Ahmed; Travis Grotz; Jennifer Leiting; Keith Fournier; Andrew J Lee; Sean Dineen; Benjamin D Powers; Andrew M Lowy; Nikhil V Kotha; Callisia Clarke; T Clark Gamblin; Sameer H Patel; Tiffany C Lee; Laura Lambert; Ryan J Hendrix; Daniel E Abbott; Kara Vande Walle; Kelly Lafaro; Byrne Lee; Fabian M Johnston; Jonathan Greer; Maria C Russell; Charles A Staley; Shishir K Maithel Journal: Ann Surg Oncol Date: 2019-06-26 Impact factor: 5.344
Authors: Evan Jost; Lloyd A. Mack; Lucas Sideris; Pierre Dube; Walley Temple; Antoine Bouchard-Fortier Journal: Can J Surg Date: 2020-02-21 Impact factor: 2.089