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Title: The Treatment of Peritoneal Carcinomatosis of Colorectal Cancer with Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Peroperative Chemotherapy (HIPEC) with Oxaliplatin: A Belgian Multicentre Prospective Phase II Clinical Study
Authors: Hompes, Daphne
D'Hoore, Andre
Van Cutsem, Eric
FIEUWS, Steffen 
Ceelen, Wim
Peeters, Marc
Bertrand, Claude
Legendre, Hugues
Kerger, Joseph
Issue Date: 2012
Publisher: SPRINGER
Source: ANNALS OF SURGICAL ONCOLOGY, 19 (7), p. 2186-2194
Abstract: Up to 25% of patients with metastatic colorectal cancer (CRC) present with peritoneal carcinomatosis (PC) as the only site of metastases. Complete cytoreductive surgery (CCRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) aims for locoregional disease control and long-term survival. Oxaliplatin is effective for treating advanced CRC. This study assesses the safety and efficacy of CCRS with HIPEC with oxaliplatin for patients with PC of CRC. A Belgian prospective multicenter registry was performed to monitor perioperative morbidity and assess mortality, disease-free survival (DFS), and overall survival (OS). Forty-eight consecutive patients underwent CCRS (R0/1) with HIPEC (male/female ratio 17/31, median age 60 years, range 24-76 years). Median PC index was 11 (range 1-22). Median operation time was 460 (range 125-840) min, with a median blood loss of 475 (range 2-6,000) ml. Thirty-day mortality was 0%. Complication rate (any grade) was 52.1%. Anastomotic leakage occurred in 10.4% of patients, bleeding in 6.3%, and bowel perforation in 2.1%. Median hospital stay was 20 (range 5-65) days. At median follow-up of 22.7 (range 3.2-55.7) months, OS was 97.9% [95% confidence interval (CI) 86.1-99.7] at 1 year and 88.7% (95% CI 73.6-95.4) at 2 years. DFS at 1 year was 65.8% (95% CI 52.3-76.2) and 45.5% (95% CI 34.3-55.9) at 2 years. Median time until recurrence was 19.8 months (95% CI 12-upper limit not defined). Only after dichotomizing PC index was a significant difference in OS found between low and high PC index. CCRS followed by HIPEC with oxaliplatin for PC from CRC can be implemented with acceptable morbidity. Long-term DFS and OS can be achieved in selected patients.
Notes: [Hompes, Daphne; D'Hoore, Andre] Univ Hosp Gasthuisberg, Dept Abdominal Surg, B-3000 Louvain, Belgium. [Van Cutsem, Eric] Univ Hosp Gasthuisberg, Dept Digest Oncol, B-3000 Louvain, Belgium. [Fieuws, Steffen] Katholieke Univ Leuven, Louvain, Belgium. [Fieuws, Steffen] Univ Hasselt, Louvain, Belgium. [Ceelen, Wim] Univ Hosp Ghent, Dept Abdominal Surg, Ghent, Belgium. [Peeters, Marc] Univ Hosp Ghent, Dept Digest Oncol, Ghent, Belgium. [Van der Speeten, Kurt] Ziekenhuis Oost Limburg, Dept Abdominal Surg, Genk, Belgium. [Bertrand, Claude] Hop Jolimont, Dept Abdominal Surg, Jolimont, Belgium. [Legendre, Hugues] UCL Mt Godinne, Dept Digest Oncol, Yvoir, Belgium. [Kerger, Joseph] UCL Mt Godinne, Dept Abdominal Surg, Yvoir, Belgium.
Keywords: Oncology; Surgery
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ISSN: 1068-9265
e-ISSN: 1534-4681
DOI: 10.1245/s10434-012-2264-z
ISI #: 000305558000017
Category: A1
Type: Journal Contribution
Validations: ecoom 2013
Appears in Collections:Research publications

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