Cytoreductive Surgery versus Systemic Chemotherapy alone in Isolated Peritoneal Carcinomatosis of Colorectal Origin

Objective: To compare the overall survival and progression-free survival of front-line cytoreductive surgery (CRs) +/- hyperthermic intraperitoneal chemotherapy versus intensive systemic chemotherapy alone, in patients with isolated peritoneal carcinomatosis of colorectal origin. Study Design: Descriptive study. Place and Duration of Study: Departments of Medical Oncology and Surgical Oncology in University of Health Sciences, Umraniye Education and Research Hospital, from January 2017 to January 2020. Methodology: Clinicopathological data of patients presented with isolated peritoneal carcinomatosis were categorised into two groups according to their treatment type as patients who received intensive systemic chemotherapy alone or underwent front-line CRS +/- HIPEC. Overall and progression-free survival outcomes of the two approaches were quantified by survival analysis and compared with each other. The other collected variables were age, gender, performance status, tumor site and type of systemic chemotherapy. Results: Overall, 109 patients were included. The median progression-free survival of patients treated with cytoreductive surgery +/- hyperthermic intraperitoneal chemotherapy was 12 months; whereas, it was 9 months in those treated with intensive systemic chemotherapy alone (p=0.011). The median overall survival was estimated as 32 months in patients treated with cytoreductive surgery +/- hyperthermic intraperitoneal chemotherapy, compared with 23 months for those treated with systemic chemotherapy alone (p=0.715). Conclusion: Although not translated into overall survival gain, extended progression-free survival, may give an advantage to cytoreductive surgery +/- hyperthermic intraperitoneal chemotherapy when used with intensive systemic chemotherapy in the individualised treatment of isolated peritoneal carcinomatosis of colorectal carcinoma.