title: [Peritoneal carcinomatosis of colorectal origin: results of cytoreductive surgery with peritonectomy and hyperthermic intraoperative chemotherapy].
abstract: Until recently peritoneal carcinomatosis (PC) arising from colorectal cancer (CRC) was considered to be a terminal disease manifestation. Despite palliative systemic chemotherapy (CHT) the majority of patients died within a few months. Nowadays cytoreductive surgery (CRS) of the peritoneal cavity in combination with hyperthermic intraperitoneal CHT and perioperative systemic CHT may offer a chance for long-term survival in selected groups of patients. In this study we report the results obtained with this treatment strategy in 30 consecutive patients. Data were assessed prospectively. After a median follow-up of 16.9 months the median survival time in all 30 patients reached 24.3 months. Favorable prognostic factors are a low extent of intraperitoneal metastases as characterized by a low peritoneal cancer index (median survival PCI ≤ 10: 33.2 months vs. PCI 11-19: 12.1 months) and a complete or nearly complete CRS (median survival CCR 0/1: 33.1 months vs. CCR2/3: 12.1 months). The 2-year overall survival was 89% for patients with a PCI ≤ 10 and 65% for those with surgical CCR 0/1 cytoreduction. As not every patient with CRC and PC may profit from this relatively aggressive therapy an interdisciplinary patient selection (tumor board) and treatment in experienced surgical oncology centers is recommended.
authors.affiliation: Chirurgisches Zentrum und Asklepios Tumorzentrum, Asklepios Paulinenklinik, Geisenheimer Str. 10, 65197, Wiesbaden, Deutschland. t.weber@asklepios.com
authors.forename: T
authors.initials: T
authors.lastname: Weber
authors.forename: M
authors.initials: M
authors.lastname: Roitman
authors.forename: K H
authors.initials: KH
authors.lastname: Link
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D033183:Interdisciplinary Communication; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000401:mortality / Q000473:pathology / Q000628:therapy; D010166:Palliative Care / Q000379:methods; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary* / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D016019:Survival Analysis