Treatment of peritoneal carcinomatosis from colorectal cancer by cytoreductive surgery and hyperthermic perioperative intraperitoneal chemotherapy.
OBJECTIVE
Peritoneal carcinomatosis from colorectal cancer is resistant to standard treatments and median survival time for patients ranges between 6 and 8 months. Aggressive cytoreductive surgery with hyperthermic intraperitoneal perioperative chemotherapy may increase median survival.


METHODS
Patients undergoing cytoreductive surgery and perioperative hyperthermic chemotherapy (mitomycin C, intraoperatively; 5-fluorouracil early post-operatively) for peritoneal carcinomatosis from colorectal cancer from 1996 to 2003 were evaluated retrospectively.


RESULTS
From 1996 to 2003, 18 cytoreductive procedures were performed. The post-operative morbidity rate was 44.4% with no treatment related mortality. The median total operation time was 5 h 28 min (range: 3 h 20 min to 7 h 10 min). The median follow-up was 21 months. The median survival was 15 months.


CONCLUSIONS
Surgical debulking and perioperative intraperitoneal chemotherapy improved survival with acceptable morbidity and mortality. Completeness of the resection was the most important prognostic indicator.
Kecmanovic
D M
DM
Department for Colorectal Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica 6, 11000 Belgrade, Serbia and Montenegro. keca@sezampro.yu
Pavlov
M J
MJ
Ceranic
M S
MS
Sepetkovski
A V
AV
Kovacevic
P A
PA
Stamenkovic
A B
AB
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D019990:Perioperative Care; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D016019:Survival Analysis; D016896:Treatment Outcome
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D016685:Mitomycin; D005472:Fluorouracil