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Long-Term Outcomes following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin

Authors :
Kadhim Taqi
Jay Lee
Scott Hurton
Cecily Stockley
Lloyd Mack
Justin Rivard
Walley Temple
Antoine Bouchard-Fortier
Source :
Current Oncology, Vol 31, Iss 7, Pp 3657-3668 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Background: Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a major treatment of colorectal peritoneal carcinomatosis (CPC). The aim was to determine the disease-free survival (DFS) and overall survival (OS) of patients undergoing CRS–HIPEC for CPC and factors associated with long-term survival (LTS). Methods: consecutive CPC patients who underwent CRS–HIPEC at a HIPEC center between 2007 and 2021 were included. Actual survival was calculated, and Cox proportional hazards models were used to identify factors associated with OS, DFS and LTS. Results: there were 125 patients with CPC who underwent primary CRS–HIPEC, with mean age of 54.5 years. Median follow-up was 31 months. Average intraoperative PCI was 11, and complete cytoreduction (CC-0) was achieved in 96.8%. Median OS was 41.6 months (6–196). The 2-year and 5-year OS were 68% and 24.8%, respectively, and the 2-year DFS was 28.8%. Factors associated with worse OS included pre-HIPEC systemic therapy, synchronous extraperitoneal metastasis, and PCI ≥ 20 (p < 0.05). Progression prior to CRS–HIPEC was associated with worse DFS (p < 0.05). Lower PCI, fewer complications, lower recurrence and longer DFS were associated with LTS (p < 0.05). Conclusion: CRS and HIPEC improve OS in CPC patients but they have high disease recurrence. Outcomes depend on preoperative therapy response, extraperitoneal metastasis, and peritoneal disease burden.

Details

Language :
English
ISSN :
17187729 and 11980052
Volume :
31
Issue :
7
Database :
Directory of Open Access Journals
Journal :
Current Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.523cf9b4de343d1ad1c8b90d4bb39c6
Document Type :
article
Full Text :
https://doi.org/10.3390/curroncol31070269