Treatment of peritoneal carcinomatosis from colorectal cancer by cytoreductive surgery and hyperthermic perioperative intraperitoneal chemotherapy

• Published in: European journal of surgical oncology Vol. 31; no. 2; pp. 147 - 152
• Main Authors: Kecmanovic, D.M., Pavlov, M.J., Ceranic, M.S., Sepetkovski, A.V., Kovacevic, P.A., Stamenkovic, A.B.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2005
• Subjects: Adult; Aged; Antibiotics, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carcinoma - mortality; Carcinoma - secondary; Carcinoma - therapy; Colorectal cancer; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - therapy; Combined Modality Therapy; Female; Fluorouracil - administration & dosage; Follow-Up Studies; Humans; Hyperthermia, Induced; Infusions, Parenteral; Intraoperative intraperitoneal chemohyperthermia; Intraperitoneal chemotherapy; Male; Middle Aged; Mitomycin - administration & dosage; Perioperative Care; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - secondary; Peritoneal Neoplasms - therapy; Peritonectomy; Retrospective Studies; Surgical Procedures, Operative; Survival Analysis; Treatment Outcome; Peritonectomy; Intraoperative intraperitoneal chemohyperthermia; Intraperitoneal chemotherapy; Colorectal cancer
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2004.09.021

Peritoneal carcinomatosis from colorectal cancer is resistant to standard treatments and median survival time for patients ranges between 6 and 8 months. Aggressive cytoreductive surgery with hyperthermic intraperitoneal perioperative chemotherapy may increase median survival.
Patients undergoing cytoreductive surgery and perioperative hyperthermic chemotherapy (mitomycin C, intraoperatively; 5-fluorouracil early post-operatively) for peritoneal carcinomatosis from colorectal cancer from 1996 to 2003 were evaluated retrospectively.
From 1996 to 2003, 18 cytoreductive procedures were performed. The post-operative morbidity rate was 44.4% with no treatment related mortality. The median total operation time was 5
h 28
min (range: 3
h 20
min to 7
h 10
min). The median follow-up was 21 months. The median survival was 15 months.
Surgical debulking and perioperative intraperitoneal chemotherapy improved survival with acceptable morbidity and mortality. Completeness of the resection was the most important prognostic indicator.