Thirty-Three Long-Term Survivors After Cytoreductive Surgery in Patients With Peritoneal Metastases From Colorectal Cancer: A Retrospective Descriptive Study
Abstract BackgroundCytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival in selected patients with peritoneal metastasis (PM) from colorectal cancer (CRC). However, little has been reported on characteristics and clinical course of long-term survivors with CRC-PM beyond 5 years. The objective of this study was to describe the clinical and oncological features affecting long-term survival of CRC-PM after comprehensive treatment.MethodsBetween January 1990 and April 2015, CRC-PM patients who underwent CRS with or without HIPEC in two Japanese tertiary hospitals and who survived longer than 5 years after the first CRS for PM were retrospectively investigated. Clinicopathological parameters and therapeutic details involved in long-term survival were reviewed. Patients were defined as cured if the recurrence-free interval was > 5 years after the last operation for metastases.ResultsThirty-three patients with a median peritoneal cancer index (PCI) of 4 (range, 1–27) were included. Complete cytoreduction was achieved in all 33 patients, and none had a rectal primary. Recurrence was observed in 19 patients (57.6%) at a median of 2.6 (range, 0.7–7.4) years. Sixteen patients (48.5%) were considered cured, of whom two never developed re-recurrence after the second surgery. The median PCI of cured group was 2 (range, 1–8).ConclusionsLong-term survival and cure were obtained after CRS in selected patients with CRC-PM. Low PCI, complete cytoreduction, and non-rectal primary are associated with long-term survival and cure in PM from CRC.