Comparison of optimally resected hepatectomy and peritonectomy patients with colorectal cancer metastasis.
BACKGROUND
Hepatectomy is the standard of care for patients with colorectal liver metastases (CRLM) but cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy (PIC) are still not widely accepted as the definitive treatment for patients with peritoneal carcinomatosis of colorectal origin (CRPC). We analyzed our data to compare survival outcomes for patients in these two groups who achieved optimal resection.


METHODS
We examined our prospectively collected database for CRLM and CRPC patients who underwent hepatectomy or peritonectomy from 1995 to 2008.


RESULTS
We identified 46 CRPC patients who achieved CCR-0/CCR-1 and 237 CRLM patients had a margin-negative hepatectomy. CRS patients had 1-, 2-, 3-, 5-year overall survival rates of 83.6%, 65.4%, 51.4%, and 32.1%, respectively. Comparatively, CRLM patients had 1-, 2-, 3-, 5-year overall survival rates of 88.1%, 69.4%, 51.9%, and 33.3%, respectively. Median survival for the two groups were 37.0 months (1-72) for CRPC patients and 37.0 months (0-120) for CRLM patients. There was no statistical significance in overall survival (P = 0.792).


CONCLUSIONS
There was no significant difference in survival outcomes for CRLM and CRPC patients who achieved optimal resection. Selected CRPC patients with potentially resectable disease should be considered for CRS and PIC.
Cao
Christopher Q
CQ
Department of Surgery, University of New South Wales, St. George Hospital, Sydney, New South Wales, Australia.
Yan
Tristan D
TD
Liauw
Winston
W
Morris
David L
DL
D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006979:Hyperthermia, Induced / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D010537:Peritoneum / Q000601:surgery*; D011446:Prospective Studies; D016019:Survival Analysis