Recurrences after Peritoneal Carcinomatosis of Colorectal Origin Treated by Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy: Location, Treatment, and Outcome
- 1 April 2004
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Annals of Surgical Oncology
- Vol. 11 (4), 375-379
- https://doi.org/10.1245/aso.2004.08.014
Abstract
Background: After treatment of peritoneal carcinomatosis of colorectal cancer origin by cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC), recurrences develop in approximately 80% of patients. This study evaluates the outcome of such recurrences after initial treatment by cytoreduction and HIPEC. Methods: Between November 1995 and May 2003, 106 patients underwent cytoreduction and HIPEC. The progression-free interval, the location of the recurrence, and its treatment were recorded. Factors potentially related to survival after recurrences were studied. Results: Sixty-nine patients had a recurrence within the study period. For patients who had undergone a gross incomplete initial cytoreduction, the median duration of survival after recurrence was 3.7 months (standard error of the mean [SE], .3). If a complete cytoreduction had been accomplished initially, the median duration of survival after the recurrence was 11.1 months (SE, .9). A shorter interval between HIPEC and recurrence was associated with shorter survival after treatment of recurrence (hazard ratio, .94; SE, .02). After effective initial treatment, a second surgical debulking for recurrent disease resulted in a median survival duration of 10.3 months (SE, 1.9), and after treatment with chemotherapy it was 8.5 months (SE, 1.6). The survival was 11.2 months (SE, .5) for patients who received radiotherapy for recurrent disease. Patients who did not receive further treatment survived 1.9 months (SE, .3). Conclusions: Treatment of recurrence after cytoreduction and HIPEC is often feasible and seems worthwhile in selected patients. Selection should be based mainly on the completeness of initial cytoreduction and the interval between HIPEC and recurrence.Keywords
This publication has 16 references indexed in Scilit:
- Randomized Trial of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy Versus Systemic Chemotherapy and Palliative Surgery in Patients With Peritoneal Carcinomatosis of Colorectal CancerJournal of Clinical Oncology, 2003
- Surgery Combined With Peritonectomy Procedures and Intraperitoneal Chemohyperthermia in Abdominal Cancers With Peritoneal Carcinomatosis: A Phase II StudyJournal of Clinical Oncology, 2003
- Factors Predicting Survival After Intraperitoneal Hyperthermic Chemotherapy With Mitomycin C After Cytoreductive Surgery for Patients With Peritoneal CarcinomatosisArchives of Surgery, 2003
- Rationale and techniques of intra-operative hyperthermic intraperitoneal chemotherapyCancer Treatment Reviews, 2001
- Hyperthermic intraperitoneal chemoperfusion in the treatment of locally advanced intra-abdominal cancerBritish Journal of Surgery, 2000
- Intraperitoneal chemohyperthermia with mitomycin C for digestive tract cancer patients with peritoneal carcinomatosisCancer, 2000
- Surgery for Recurrent Colon Cancer: Strategies for Identifying Resectable Recurrence and Success Rates after ResectionAnnals of Internal Medicine, 1998
- A prospective randomized study of follow-up after radical surgery for colorectal cancerBritish Journal of Surgery, 1997
- Local recurrence of colorectal cancer: The problem, mechanisms, management and adjuvant therapyBritish Journal of Surgery, 1994
- Sites of recurrent tumour after ‘curative’ colorectal surgery: Implications for adjuvant therapyBritish Journal of Surgery, 1984