Abstract
Background
The objective of this study was to report a long-term survival analysis of a phase
II protocol of cytoreductive surgery (CS) and heated intraperitoneal chemotherapy
(HIPEC) in the treatment of peritoneal carcinomatosis (PCs).
Methods
Between 2000 and 2008, 101 consecutive patients were treated with CS, HIPEC and early
postoperative intraperitoneal chemotherapy using a standardized protocol. Disease
recurrence and mortality data were collected prospectively. Primary outcomes were
median, 3-year, and 5-year disease-free survival (DFS) and overall survival (OS).
Results
The median age was 49 years (range, 18–77 years), and the majority (82%) had complete
CS with no gross residual cancer. Tumor types included appendiceal (n = 58), colorectal
(n = 31), and other (n = 12). Median follow-up was 28 months (range, 0–119 months),
with minimum of 24 months among survivors. For appendiceal tumors, median DFS was
34 months (range, 0–119 months) and OS has not yet been defined. Three-year and 5-year
DFS was 48% and 42%, respectively, and 3-year and 5-year OS was 76% and 62%, respectively.
For colorectal carcinomatosis, median disease-free and OS was 9 months (range, 0–87
months) and 27 months (range, 0–87 months), respectively. Three-year and 5-year DFS
was 34% and 26%, respectively, and 3-year and 5-year OS was 38% and 34%, respectively.
Conclusions
Long-term survival with regional treatment of PC from appendiceal or colorectal primary
tumors with CS and HIPEC is achievable.
Keywords
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References
- Natural history of peritoneal carcinomatosis from nongynecologic malignancies.Surg Oncol Clin N Am. 2003; 12: 729-739
- Rationale for integrating early postoperative intraperitoneal chemotherapy into the surgical treatment of gastrointestinal cancer.Semin Oncol. 1989; 16: 83-97
- Long-term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy.Ann Surg. 2005; 241: 300-308
- A systematic review on the efficacy of cytoreductive surgery and perioperative intraperitoneal chemotherapy for pseudomyxoma peritonei.Ann Surg Oncol. 2007; 14: 484-492
- Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to “pseudomyxoma peritonei.”.Am J Sug Pathol. 1995; 19: 1390-1408
- Survival analysis of pseudomyxoma peritonei patients treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.Ann Surg. 2007; 245: 104-109
- Canadian cancer statistics 2010.Canadian Cancer Society, Toronto2010
- Potentially curative surgery of colon cancer: patterns of failure and survival.J Clin Oncol. 1988; 6: 106-118
- Peritoneal carcinomatosis in non-gynecologic malignancy.Cancer. 1989; 63: 364-367
- Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study.Cancer. 2000; 88: 358-363
- Peritoneal carcinomatosis from colorectal cancer.Br J Surg. 2002; 89: 1545-1550
- Leucovorin and fluorouracil with and without oxaliplatin as first-line treatment in advanced colorectal cancer.J Clin Oncol. 2000; 18: 2938-2947
- Conventional surgery and systemic chemotherapy for peritoneal carcinomatosis of colorectal origin: a prospective study.Eur J Surg Oncol. 2005; 31: 1145-1151
- 8-year follow-up of randomized trial: cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer.Ann Surg Oncol. 2008; 15: 2426-2432
- Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study.J Clin Oncol. 2004; 22: 3284-3292
- Peritoneal colorectal carcinomatosis treated with surgery and perioperative intraperitoneal chemotherapy: retrospective analysis of 523 patients from a multicentric French study.J Clin Oncol. 2010; 28: 1808
- Phase II study of regional treatment for peritoneal carcinomatosis.Am J Surg. 2009; 197: 614-618
- Peritonectomy procedures.Cancer Treat Res. 1996; 82: 235-253
- Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding.Br J Surg. 2004; 91: 304-311
- Long-term survival of peritoneal carcinomatosis of colorectal origin.Ann Surg Oncol. 2005; 12: 65-71
- Curative treatment of colorectal peritoneal carcinomatosis: current status and future trends.Eur J Surg Oncol. 2009; 36: 599-603
- A prospective comparison of cytoreductive surgery plus heated intraperitoneal chemotherapy and early postoperative chemotherapy vs. heated intraperitoneal chemotherapy alone in the treatment of peritoneal carcinomatosis.Ann Surg Oncol. 2010; 17: S8
Article info
Publication history
Received in revised form:
January 6,
2011
Received:
November 8,
2010
Footnotes
A standardized phase II protocol of cytoreductive surgery and heated intraperitoneal chemotherapy for the treatment of gastrointestinal carcinomatosis was analyzed for long-term survival. For appendix tumors and colorectal tumors, 5-year survival was 62% and 34%, respectively.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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