Long-Term Outcomes After R0 Resection of Synchronous Peritoneal Metastasis from Colorectal Cancer Without Cytoreductive Surgery or Hyperthermic Intraperitoneal Chemotherapy

2017 ◽  
Vol 25 (1) ◽  
pp. 173-178 ◽  
Author(s):  
Dai Shida ◽  
Shunsuke Tsukamoto ◽  
Hiroki Ochiai ◽  
Yukihide Kanemitsu
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
R0 Resection ◽  
Long Term Outcomes

scholarly journals Cytoreductive Surgery Combined with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Colorectal Cancer

2020 ◽  
Vol 33 (06) ◽  
pp. 372-376
Author(s):  
Hideaki Yano
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Systemic Disease ◽  
Good Reason ◽  
Standard Of Care ◽  
Peritoneal Cancer

AbstractPeritoneal metastasis from colorectal cancer (PM-CRC) is used to be considered a systemic and fatal condition; however, it has been growingly accepted that PM-CRC can still be local disease rather than systemic disease as analogous to liver or lung metastasis.Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is now considered an optimal treatment for PM-CRC with accumulating evidence. There is a good reason that CRS + HIPEC, widely accepted as a standard of care for pseudomyxoma peritonei (PMP), could be a viable option for PM-CRC given a similarity between PM-CRC and PMP.Recent years have also seen that modern systemic chemotherapy with or without molecular targeted agents can be effective for PM-CRC. It is possible that neoadjuvant or adjuvant chemotherapy combined with CRS + HIPEC could further improve outcomes.Patient selection, utilizing modern images and increasingly laparoscopy, is crucial. Particularly, diagnostic laparoscopy is likely to play a significant role in predicting the likelihood of achieving complete cytoreduction and assessing the peritoneal cancer index score.

scholarly journals Outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer with peritoneal metastasis

Medicine ◽  
2016 ◽  
Vol 95 (52) ◽  
pp. e5522 ◽  
Author(s):  
En-Kwang Lin ◽  
Mao-Chih Hsieh ◽  
Chien-Hsin Chen ◽  
Yen-Jung Lu ◽  
Szu-Yuan Wu
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy

scholarly journals Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei of Appendiceal Origin---801 Cases from a Single Institution in China

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Ao Xia ◽  
Xichao Zhai ◽  
Lubiao An ◽  
Bing Wang ◽  
Guanjun Shi ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Pseudomyxoma Peritonei ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Peritoneal Cancer Index ◽  
Univariate Analysis ◽  
Long Term Outcomes ◽  
Peritoneal Cancer ◽  
Tumor Debulking

Aim: As more and more centers has published their treatment results of pseudomyxoma peritonei (PMP) with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), the data from China is missing. Myxoma Department of Aerospace Hospital is the biggest center treating PMP in China. The purpose of this study is to report the early and long-term outcomes for PMP from this single center.Methods: 801 appendix-derived PMP out of 1008 consecutive patients treated in Myxoma Department of Aerospace Hospital between 2008 and 2019 were retrospectively analyzed.Results: Complete cytoreductive surgery (CCRS) was achieved in 240 (30%) patients with median PCI of 14(1~39), and the rest had maximal tumor debulking (MTD), HIPEC was implemented in 96.3% of CCRS and 78.6% of MTD. The major morbidity (grade III/IV) was 11.4% and the 30-day operative mortality is 0.7%. The 5- and 10-year OS of CCRS was 76.9% and 64.1%, which is significantly higher than MTD (5-, 10-year OS as 36.1%, 27.1%; p<0.001). On the univariate analysis, all prognostic factors (gender, PSS, interval time, prior chemotherapy, prior HIPEC, Peritoneal Cancer Index (PCI), completeness of cytoreduction (CC), HIPEC, pathology, present of serous ascites) were found to be associated with overall survival except for age. On multivariate analysis, only PCI>20, MTD, high pathologic grade and without HIPEC were independent factors predicting poorer prognosis.Conclusions: CCRS +HIPEC can benefit PMP well with controllable risks. MTD+HIPEC may benefit PMP as well when CCRS cannot be achieved after fully asscessment by an experienced peritoneal maglignacy center, but the surgery should be performed as limited as possible.

scholarly journals Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Younger Patients with Peritoneal Metastasis from Colorectal Cancer

2021 ◽  
Author(s):  
Haipeng Chen ◽  
Sicheng Zhou ◽  
Yujuan Jiang ◽  
Zhaoxu Zheng ◽  
Zheng Liu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Older Patients ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Cox Regression ◽  
Young Patients ◽  
Cancer Specific Survival ◽  
Younger Patients

Abstract Background Currently, few studies have evaluated effectiveness of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in young patients with peritoneal metastasis (PM) of colorectal cancer (CRC) origin.Method Clinicopathological characteristics, perioperative data and survival outcomes in young patients, defined as being 50 years or less (n=23), performing CRS+HIPEC between June 2017 to June 2019 were reviewed and compared with older patients, defined as aged over 50 years (n=47).Results Compared with older patients, young patients were more likely to present with PM at the time of diagnosis (78.3% vs 51.1%, P=0.029) and exhibit a mucinous and signet-ring histology (60.9% vs 29.8%, P=0.013). The cancer-specific survival (CSS) after CRS+HIPEC in two groups are similar. On multivariate Cox regression, rectal origin (HR, 2.51, 95%CI, 1.11-5.67; P=0.027) and mucinous/signet adenocarcinoma (HR, 2.20, 95%CI, 1.02-4.74; P=0.044) were independent risk factors for poor CSS.Conclusion Younger patients (aged ≤50 years) with PM of CRC origin presented more often with synchronous PM than older patients. Although tend to exhibit a aggressive nature, they derive similar benefit from CRS+HIPEC as older patients.

scholarly journals Effect of oxaliplatin-based chemotherapy on chemosensitivity in patients with peritoneal metastasis from colorectal cancer treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: proof-of-concept study

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
A Prabhu ◽  
A Brandl ◽  
S Wakama ◽  
S Sako ◽  
H Ishibashi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Collagen Gel ◽  
Progression Free Survival ◽  
Chemosensitivity Testing ◽  
Therapeutic Decision Making ◽  
The Impact

Abstract Background Chemosensitivity testing, including collagen gel droplet-embedded culture drug sensitivity test, has proven to be a useful tool in therapeutic decision-making. This retrospective analysis investigated chemosensitivity testing of peritoneal metastases collected during cytoreductive surgery (CRS), and its impact on survival in patients with colorectal cancer. Methods All patients with peritoneal metastasis from colorectal cancer who underwent CRS with or without hyperthermic intraperitoneal chemotherapy (HIPEC) between November 2008 and October 2014 were included. The growth inhibition rate was expressed as the ratio between the image density after treatment (T) and that before treatment (control, C). Tumours with a reduction in T/C ratio of less than 20 per cent were defined as resistant and those with a reduction of 20 per cent or more as sensitive. Groups were compared for overall (OS) and disease-free (DFS) survival. Results Of 84 eligible patients, 81 received neoadjuvant chemotherapy (NACT), including 56 patients with an oxaliplatin-based regimen. Mean(s.d.) follow-up was 23·4(22·9) months. The median overall survival of all patients was 19·0 (i.q.r. 5·7–36·1) months, with a progression-free survival time of 10·1 (4·5–17·0) months. Patients who received oxaliplatin-based NACT had significantly altered chemosensitivity to oxaliplatin; only 20 of 51 such patients showed chemosensitivity to oxaliplatin compared with 16 of 24 who did not undergo oxaliplatin-based NACT (P = 0·046). However, patients who showed chemoresistance to oxaliplatin had similar OS to those with chemosensitivity (18·8 versus 18·1 months; P = 0·835). The choice of HIPEC agents in patients who received oxaliplatin-based NACT did not significantly influence survival (oxaliplatin versus mitomycin C: median OS 20·6 (10·9–24·8) versus 19·0 (10·5–34·6) months, P = 0·811; DFS 6·6 (2·8–25·7) versus 9·3 (4·1–13·9) months, P = 0·191). Conclusion Patients who had oxaliplatin-based NACT showed a higher rate of chemoresistance to oxaliplatin at the time of CRS and HIPEC. The impact of chemosensitivity testing on OS remains unclear and needs further investigation.

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