The long-term clinical efficacy of tumor cytoreduction surgery with hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer / 解放军医学杂志

ABSTRACT

Objective: To study the long-term efficacy of cytoreduction surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis from colorectal cancer. Methods: The clinical data were collected of 103 patients with peritoneal carcinomatosis (PC) from colorectal cancer undergoing CRS with HIPEC in the Department of General Surgery of the First Medical Center of Chinese PLA General Hospital from January 1, 2012 to May 31, 2013, and divided into colonic group (n=60) and rectal group (n=43) according to the origin position of peritoneal cancer. The surgical status of patients (whether combined with other organ resection, number of stoma, peritoneal carcinomatosis index (PCI), completeness of cytoreduction (CC) score, transfusion, etc.) and the short-term complications and long-term survival after operation in the both groups were compared. Kaplan-meier method was used to draw the survival curve of patients, and log-rank method was employed to compare the survival differences between the two groups. Results: There was no significant difference in the surgical data between the two groups (PCI, CC score, hepatectomy, number of anastomosed stoma, transfusion, etc., P>0.05). The follow-up time of the 103 patients was (28.43±15.65) months, median survival time (OS) was 26.3 months, median disease free survival time (DFS) was 17.7 months, median recurrence to time of death (TTD) was 18.3 months. The 3-year and 5-year survival rate were 35.9% and 8.7%, respectively. The patients' survival was better in colonic group than in rectal group (OS 28.5 months vs. 19.7 months; DFS 21.1 months vs. 13.6 months; TTD 22.3 months vs. 12.1months; 3-year survival rate 48.3% vs. 18.6%; 5-year survival rate 15.0% vs. 0, P<0.05). Conclusion: When CRS with HIPEC is implemented, the incidence of short-term complications in patients with PC originated from colon may match to those with PC originated from rectum, while the long-term efficacy is better in the former than in the latter.