title: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal and gastrointestinal origin shows acceptable morbidity and high survival.
abstract: BACKGROUND
  Peritoneal carcinomatosis from colorectal origin carries a poor prognosis. Recent clinical studies show that cytoreductive surgery (CS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) improves survival of selected patients with a colorectal carcinoma and isolated peritoneal carcinomatosis in the absence of extra-abdominal metastases. Here, we report the clinical outcomes and survival after cytoreductive surgery and HIPEC of the first cohort of patients treated in our institution.
  
  
  METHODS
  Sixty-seven patients underwent a laparotomy. Complete cytoreduction could be performed in 49 patients, who underwent a total of 53 CS-HIPEC procedures. All had peritoneal carcinomatosis originating from primary colorectal, cecal, appendiceal, and gastric tumors.
  
  
  RESULTS
  In patients who underwent CS-HIPEC, an R0 resection could be achieved in 4%, R1 in 88%, and R2 in 8%. The 30-day mortality was 0; one patient died in-hospital after 10 weeks. The median hospital stay was 12 days (range 4-56). The overall morbidity was 43%, including extended gastroparesis (11%), anastomotic failure (11%) and intra-abdominal abscess (9%). Mean time to clinical recurrence was 12 months (range 4-22). The actuarial 1-year survival was 88% and 2-year survival was 75%.
  
  
  CONCLUSIONS
  In well-selected patients referred to a specialized institution, CS-HIPEC has an acceptable morbidity and high survival rate.
authors.affiliation: Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Hagendoorn
authors.forename: G
authors.initials: G
authors.lastname: van Lammeren
authors.forename: D
authors.initials: D
authors.lastname: Boerma
authors.forename: E
authors.initials: E
authors.lastname: van der Beek
authors.forename: M J
authors.initials: MJ
authors.lastname: Wiezer
authors.forename: B
authors.initials: B
authors.lastname: van Ramshorst
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents