CR14 EFFICACY OF PERITONECTOMY FOR PERITONEAL CARCINOMATOSIS FROM COLORECTAL CANCER

Purpose  The objectives of this report were to critically evaluate the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy (peritonectomy) for patients with peritoneal carcinomatosis from colorectal carcinoma. Methodology  Forty patients with histologically confirmed peritoneal dissemination from colorectal cancer underwent peritonectomy at the St George Hospital, Sydney. All clinical and treatment‐related data were prospectively collected. Perioperative and survival results were analysed by intention‐to‐treat principle. Results  The mean age at the time of surgery was 54 (S.D. = 14) years. There were 25 male patients. Three, 20 and 17 patients had well‐, moderately‐ and poorly‐differentiated tumours. The mean peritoneal cancer index was 12 (S.D. = 9). The mean operation duration was 7 (S.D. = 4) hours. The mean ICU, HDU and overall hospital stay was 1 (S.D. = 0.5), 5 (S.D. = 8) and 28 (S.D. = 34) days, respectively. Seventeen patients (42%) had moderate morbidity and required interventional procedures for resolution. Six patients (15%) had severe morbidity and required returning to ICU or operating theatre for management. There was no operative death. After a median follow‐up of 12 months since peritonectomy, the overall median survival was 30 months (range 1 to 46), with 1‐ and 2‐year survival of 67% and 61%, respectively. Conclusions  Peritonectomy is a treatment option for selected patients with peritoneal carcinomatosis from colorectal carcinoma.