Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal peritoneal metastases: analysis of short- and long-term outcomes
被引:10
作者:
Rosa, Fausto
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机构:
Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Digest Surg, Largo A Gemelli 8, I-00168 Rome, Italy
Univ Cattolica Sacro Cuore, Rome, ItalyFdn Policlin Univ Agostino Gemelli IRCCS, Dept Digest Surg, Largo A Gemelli 8, I-00168 Rome, Italy
Rosa, Fausto
[1
,2
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Galiandro, Federica
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Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Digest Surg, Largo A Gemelli 8, I-00168 Rome, ItalyFdn Policlin Univ Agostino Gemelli IRCCS, Dept Digest Surg, Largo A Gemelli 8, I-00168 Rome, Italy
Background Peritoneal metastases carry the worst prognosis among all sites of colorectal cancer (CRC) metastases. In recent years, the advent of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival for selected patients with limited peritoneal involvement. We report the evolution of CRS and HIPEC for colorectal peritoneal metastases at a tertiary referral center over a 10-year period. Methods Patients with colorectal peritoneal metastases undergoing CRS and HIPEC were included and retrospectively analyzed at a tertiary referral center from January 2006 to December 2015. Main outcomes included evaluation of grade III/IV complications, mortality rate, overall and disease-free survival, and prognostic factors influencing survival on a Cox multivariate analysis. Results Sixty-seven CRSs were performed on 67 patients during this time for colorectal peritoneal metastases. The median patient age was 57 years with 55.2% being female. The median peritoneal carcinomatosis index (PCI) was 7, with complete cytoreduction achieved in 65 (97%) cases. Grade > 2 complications occurred in 6 cases (8.9%) with no mortality. The median overall survival for the entire cohort was 41 months, with a 3-year overall survival of 43%. In case of complete cytoreduction, median overall and disease-free survival were 57 months and 36 months respectively, with a 3-year disease-free survival of 62%. Complete cytoreduction and nonmucinous histology were key factors independently associated with improved overall survival. Conclusions CRS and HIPEC for limited peritoneal metastases from CRC are safe and effective, with acceptable morbidity. In selected patients, it offers a highly favorable long-term outcomes.
机构:
Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Reina Sofia Univ Hosp, Gen Surg & Gastroenterol Dept, Ave Menendez Pidal S-N, Cordoba 14004, SpainWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Casado-Adam, Angela
Alderman, Robert
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Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Alderman, Robert
Stuart, O. Anthony
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Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Stuart, O. Anthony
Chang, David
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Westat Corp, Rockville, MD 20850 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Chang, David
Sugarbaker, Paul H.
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Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
机构:
Changhua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Cent Taiwan Univ Sci & Technol, Dept Med Imaging & Radiol Sci, Taichung, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Chang, Ming-Che
Chen, Jin-Hua
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机构:
China Med Univ, Coll Med, Ctr Biostat, Taichung, Taiwan
China Med Univ, Coll Med, Grad Inst Biostat, Taichung, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Chen, Jin-Hua
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机构:
Liang, Ji-An
Huang, Wen-Sheng
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机构:
Changhua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Triserv Gen Hosp, Dept Nucl Med, Taipei, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
机构:
China Med Univ, Coll Med, Grad Inst Clin Med Sci, Taichung, Taiwan
China Med Univ, Coll Med, Sch Med, Taichung, Taiwan
China Med Univ Hosp, Dept Nucl Med, Taichung 404, Taiwan
China Med Univ Hosp, PET Ctr, Taichung 404, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
机构:
Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Reina Sofia Univ Hosp, Gen Surg & Gastroenterol Dept, Ave Menendez Pidal S-N, Cordoba 14004, SpainWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Casado-Adam, Angela
Alderman, Robert
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机构:
Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Alderman, Robert
Stuart, O. Anthony
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h-index: 0
机构:
Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Stuart, O. Anthony
Chang, David
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h-index: 0
机构:
Westat Corp, Rockville, MD 20850 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
Chang, David
Sugarbaker, Paul H.
论文数: 0引用数: 0
h-index: 0
机构:
Washington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USAWashington Hosp Ctr, Washington Canc Inst, Washington, DC 20010 USA
机构:
Changhua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Cent Taiwan Univ Sci & Technol, Dept Med Imaging & Radiol Sci, Taichung, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Chang, Ming-Che
Chen, Jin-Hua
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h-index: 0
机构:
China Med Univ, Coll Med, Ctr Biostat, Taichung, Taiwan
China Med Univ, Coll Med, Grad Inst Biostat, Taichung, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Chen, Jin-Hua
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机构:
Liang, Ji-An
Huang, Wen-Sheng
论文数: 0引用数: 0
h-index: 0
机构:
Changhua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
Triserv Gen Hosp, Dept Nucl Med, Taipei, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan
机构:
China Med Univ, Coll Med, Grad Inst Clin Med Sci, Taichung, Taiwan
China Med Univ, Coll Med, Sch Med, Taichung, Taiwan
China Med Univ Hosp, Dept Nucl Med, Taichung 404, Taiwan
China Med Univ Hosp, PET Ctr, Taichung 404, TaiwanChanghua Christian Hosp, Dept Nucl Med, Changhua, Taiwan