Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal and gastrointestinal origin shows acceptable morbidity and high survival

Background: Peritoneal carcinomatosis front colorectal origin carries a poor prognosis. Recent clinical Studies show that cytoreductive surgery (CS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves Survival of selected patients with a colorectal carcinoma and isolated peritoneal carcinomatosis in the absence of extra-abdominal metastases. Here, we report the clinical outcomes and survival after cytoreductive surgery and HIPEC of the first cohort of patients treated in our institution.

Methods: Sixty-seven patients underwent a laparotomy. Complete cytoreduction could be performed in 49 patients, who underwent a total of 53 CS-HIPEC procedures. All had peritoneal carcinomatosis originating front primary colorectal. cecal, appendiceal, and gastric tumors.

Results: In patients who underwent CS-HIPEC, an R0 resection could be achieved in 4%, R1 in 88%, and R2 in 8%. The 30-day mortality wits 0; one patient died in-hospital after 10 weeks. The median hospital stay was 12 days (range 4-56). The overall morbidity wits 43%, including extended gastroparesis (11%), anastomotic failure (11%) and intra-abdominal abscess (9%). Mean time to clinical recurrence was 12 months (range 4-22). The actuarial 1-year survival was 88% and 2-year survival was 75%.

Conclusion In well-selected patients referred to a specialized institution. CS-HIPEC has an acceptable morbidity and high survival rate. (C) 2008 Elsevier Ltd. All rights reserved.