Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy With Mitomycin C Used for Colorectal Peritoneal Carcinomatosis

• Published in: Annals of coloproctology Vol. 36; no. 1; pp. 22 - 29
• Main Authors: Roh, Seung Jae, Park, Sung Chan, Choi, Jaehee, Lee, Joon Sang, Lee, Dong Woon, Hong, Chang Won, Han, Kyung Su, Park, Hyoung Chul, Sohn, Dae Kyung, Oh, Jae Hwan
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Coloproctology 01-02-2020; 대한대장항문학회
• Subjects: colorectal neoplasms; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; Original; peritoneal carcinomatosis; 일반외과학; Hyperthermic intraperitoneal chemotherapy; Colorectal neoplasms; Cytoreductive surgery; Peritoneal carcinomatosis
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2019.04.30

This study aimed to assess the evaluation of clinical outcomes and consequences of complications after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for the peritoneal carcinomatosis (PC) from colorectal cancer.
A total 26 patients underwent CRS and HIPEC for PC from colorectal cancer between March 2009 and April 2018. All the patients underwent CRS with the purpose of complete or near-complete cytoreduction. Intraoperative HIPEC was performed simultaneously after the CRS. Mitomycin C was used as chemotherapeutic agent for HIPEC.
Median disease-free survival was 27.8 months (range, 13.4-42.2 months). Median overall survival was 56.0 months (range, 28.6-83.5 months). The mean peritoneal cancer index (PCI) was 8.73 ± 5.54. The distributions thereof were as follows: PCI <10, 69.23%; PCI 10-19, 23.08%; and PCI ≥20, 7.69%. The completeness of cytoreduction was 96.2% of patients showed CC-0, with 3.8% achieved CC-1. The mean operation time was 8.5 hours, and the mean postoperative hospital stay was 21.6 days. The overall rate of early postoperative complications was 88.5%; the rate of late complications was 34.6%. In the early period, most complications were grades I-II complications (65.4%), compared to grades III-V (23.1%). All late complications, occurring in 7.7% of patients, were grades III-V. There was no treatment-related mortality.
Although the complication rate was approximately 88%, but the rate of severe complication rate was low. In selective patients with peritoneal recurrence, more aggressive strategies for management, such as CRS with HIPEC, were able to be considered under the acceptable general condition and life-expectancy.