title: Is there a possibility of a cure in patients with colorectal peritoneal carcinomatosis amenable to complete cytoreductive surgery and intraperitoneal chemotherapy?
abstract: BACKGROUND
  Although a randomized trial demonstrated a survival benefit of cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) over systemic chemotherapy alone, the treatment of peritoneal carcinomatosis from colorectal cancer (CRPC) is still a matter of debate. The aims of this study were to evaluate long-term outcome after CRS and IPC and to identify the prognostic factors associated with a cure.
  
  
  METHODS
  Patients were considered cured if the disease-free survival interval lasted at least 5 years after the treatment of CRPC or its last recurrence. Patients who had died postoperatively, or from non-cancer-related deaths, or patients with a follow-up of less than 5 years since the last curative treatment were excluded from the analysis.
  
  
  RESULTS
  From 1995 to 2006, 107 patients (median age, 48 years; range, 19-67 years) underwent complete CRS, followed by IPC. Postoperative complications occurred in 50 patients (53%), including 4 postoperative deaths. After a median follow-up of 77 months (range, 60-144 months), 5-year and 10-year overall survival rates were 35% and 15%, respectively. Seventeen patients (16%) were considered cured after a disease-free interval of at least 5 years, of whom 14 never developed a recurrence. Cured patients had a significantly lower median peritoneal cancer index than noncured patients, respectively 4 (3-16) and 12 (2-36) (P = 0.0002). In multivariate analysis, a peritoneal cancer index of 10 or less was the only independent factor predicting cure.
  
  
  CONCLUSIONS
  The cure rate (16%) after complete CRS of colorectal peritoneal carcinomatosis, followed by IPC, in selected patients is close to that obtained after resection of colorectal liver metastases.
authors.affiliation: Department of Surgical Oncology, Institut Gustave Roussy, Villejuif Cedex, France. goere@igr.fr
authors.forename: Diane
authors.initials: D
authors.lastname: Goéré
authors.forename: David
authors.initials: D
authors.lastname: Malka
authors.forename: Dimitri
authors.initials: D
authors.lastname: Tzanis
authors.forename: Vinicius
authors.initials: V
authors.lastname: Gava
authors.forename: Valérie
authors.initials: V
authors.lastname: Boige
authors.forename: Clarisse
authors.initials: C
authors.lastname: Eveno
authors.forename: Léon
authors.initials: L
authors.lastname: Maggiori
authors.forename: Frédéric
authors.initials: F
authors.lastname: Dumont
authors.forename: Michel
authors.initials: M
authors.lastname: Ducreux
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D010478:Chemotherapy, Cancer, Regional Perfusion; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome