Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Carcinomatosis of Colorectal Origin

Abstract

Purpose : Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) has been recognized as an active treatment for peritoneal carcinomatosis of colorectal origin. However, the high rates of postoperative complication and recurrence remain to be solved. The purpose of this study was to clarify the feasibility and the clinical benefit of CRS+HIPEC.

Methods : The data of 11 patients who underwent CRS+HIPEC for peritoneal carcinomatosis of colorectal origin were retrieved. CRS was performed using peritonectomy procedures proposed by Sugarbaker, and HIPEC was administered using MMC and CDDP.

Results : The median value of the peritoneal cancer index (PCI), which represents the tumor burden of peritoneal carcinomatosis, was 14, and complete cytoreduction was achieved in all cases. Morbidity of grade ≥ 3 was observed as arrhythmia in one case, and there was no incidence of 90-day mortality. Early recurrence after adjuvant chemotherapy was observed in 7 cases. Median survival after the start of treatment was 26.4 months.

Conclusion : Our results showed that CRS+HIPEC was safe ; however, early recurrence was frequent. It was suggested that more precise patient selection was necessary by more accurate preoperative evaluation of PCI and chemosensitivity.