Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic colorectal cancer with peritoneal surface disease

2015 ◽  
pp. 235-244
Author(s):  
Edward A. Levine ◽  
Chukwuemeka Obiora
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Surface

scholarly journals Treatment of peritoneal surface neoplasms with intraperitoneal chemotherapy in hyperthermia

2015 ◽  
Vol 125 (1) ◽  
pp. 20-23
Author(s):  
Jerzy Mielko ◽  
Bogumila Ciaseł ◽  
Magdalena Skórzewska ◽  
Robert Sitarz ◽  
Andrzej Kurylcio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Gastric Cancer ◽  
Ovarian Cancer ◽  
Metastatic Colorectal Cancer ◽  
Peritoneal Carcinomatosis ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Research Group ◽  
Secondary Neoplasms ◽  
Peritoneal Surface

Abstract Effective treatment of peritoneal surface neoplasms is possible through the simultaneous use of cytoreductive surgery with intraperitoneal chemotherapy in hyperthermia. It is successfully performed in patients with peritoneal pseudomyxoma, mesothelioma, as well as a limited and resectable peritoneal carcinomatosis in the course of colorectal cancer. It can also be used in patients with gastric or ovarian cancer but also metastatic colorectal cancer or metastases to the ovaries from gastric cancer. Aggressive surgical management of patients with primary or secondary neoplasms of the peritoneal surface was initiated by Sugarbaker’s research group.

Long-term survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy compared with hepatic resection for metastatic colorectal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 630-630 ◽  
Author(s):  
Aaron Udell Blackham ◽  
Greg B. Russell ◽  
John H. Stewart ◽  
Konstantinos Ioannis Votanopoulos ◽  
Edward Allen Levine ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Resection ◽  
Hepatic Resection ◽  
Metastatic Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Performance Status ◽  
Term Survival ◽  
Disease Free

630 Background: Surgical resection of peritoneal metastases (PM) from colorectal cancer has been reported to yield outcomes similar to liver resection for hepatic metastases (HM). However recent data suggests PM may have a worse prognosis than other metastatic sites. Methods: A review of metastatic colorectal cancer patients obtained from prospective databases (1992-2010) comparing liver resection for HM to cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for PM. Results: 181 patients underwent hepatic resection and 182 patients underwent CS/HIPEC with a median follow-up of 55 and 106 months respectively. A margin-negative resection was obtained in 168 (93%) hepatic resections, while 89 patients (49%) with PM had complete cytorection of all gross disease (R0/R1). A comparison of these two groups demonstrated significant differences in age, pre-operative chemotherapy and performance status. Disease-free median survival was 15.2 months after hepatic resection and 9.9 months after CS/ HIPEC (p=0.02). The 5-year overall survival (OS) for HM patients was 33% with a median OS of 45.0 months; while 5-year OS was 23% and median OS was 32.3 months for PM patients (p=0.02). In a proportional hazards regression model, performance status and pre-operative chemotherapy had no significant effect on survival, while increased age (p=0.02) and PM (p=0.03) were associated with decreased OS. Postoperative morbidity was 38% versus 51% (p=0.04) and mortality was 3.0% versus 2.3% (p=0.73) in the HM and PM groups, respectively. Conclusions: Disease-free survival and OS are worse for patients who received complete cytoreduction and CS/HIPEC for PM compared to margin-negative liver resection for HM suggesting a more aggressive tumor biology in PM.

scholarly journals Cytoreductive Surgery Combined with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Colorectal Cancer

2020 ◽  
Vol 33 (06) ◽  
pp. 372-376
Author(s):  
Hideaki Yano
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Systemic Disease ◽  
Good Reason ◽  
Standard Of Care ◽  
Peritoneal Cancer

AbstractPeritoneal metastasis from colorectal cancer (PM-CRC) is used to be considered a systemic and fatal condition; however, it has been growingly accepted that PM-CRC can still be local disease rather than systemic disease as analogous to liver or lung metastasis.Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is now considered an optimal treatment for PM-CRC with accumulating evidence. There is a good reason that CRS + HIPEC, widely accepted as a standard of care for pseudomyxoma peritonei (PMP), could be a viable option for PM-CRC given a similarity between PM-CRC and PMP.Recent years have also seen that modern systemic chemotherapy with or without molecular targeted agents can be effective for PM-CRC. It is possible that neoadjuvant or adjuvant chemotherapy combined with CRS + HIPEC could further improve outcomes.Patient selection, utilizing modern images and increasingly laparoscopy, is crucial. Particularly, diagnostic laparoscopy is likely to play a significant role in predicting the likelihood of achieving complete cytoreduction and assessing the peritoneal cancer index score.

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