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Patterns of recurrence following complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with peritoneal carcinomatosis of colorectal cancer
Author(s) -
Braam Hidde J.,
van Oudheusden Thijs R.,
de Hingh Ignace H.J.T.,
Nienhuijs Simon W.,
Boerma Djamila,
Wiezer Marinus J.,
van Ramshorst Bert
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23597
Subject(s) - medicine , hyperthermic intraperitoneal chemotherapy , cytoreductive surgery , colorectal cancer , chemotherapy , peritoneal carcinomatosis , surgery , proportional hazards model , cancer , oncology , ovarian cancer
Background and Objectives CytoReductive Surgery (CRS) combined with Hyperthermic IntraPEritoneal Chemotherapy (HIPEC) has an established role in the treatment of peritoneally metastasized colorectal cancer. The aim of the study was to describe the recurrence patterns and to evaluate treatment options and related survival. Methods Patients treated with CRS + HIPEC in two tertiary referral centers between April 2005 and March 2013 were analyzed retrospectively. The prognostic value of several parameters was calculated using Cox Regression. Results One hundred thirty two of 287 patients (46%) with peritoneal carcinomatosis treated with complete CRS and HIPEC were diagnosed with recurrent disease, after a median disease‐free interval of 11.4 months. Recurrence were locoregional (43%), distant metastases (26%) or both (31%). Thirty‐two of the 132 patients with recurrences (24%) were treated surgically with curative intent, which extended the median survival from 12 months to 43 months, compared to palliative treatment (best supportive care or chemotherapy; P < 0.001). Initial nodal status ( P = 0.01) and the number of affected regions at initial CRS ( P = 0.02) were significantly correlated to survival after disease recurrence. Conclusion Disease recurrence after CRS and HIPEC is common; in selected patients, an aggressive surgical approach may be beneficial and extend survival. J. Surg. Oncol. 2014 109:841–847 . © 2014 Wiley Periodicals, Inc.