title: Prognostic factors of peritoneal metastases from colorectal cancer following cytoreductive surgery and perioperative chemotherapy.
abstract: BACKGROUND
  Prolonged survival of patients affected by peritoneal metastasis (PM) of colorectal origin treated with complete cytoreduction followed by intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) has been reported. However, two-thirds of the patients after complete cytoreduction and perioperative chemotherapy (POC) develop recurrence. This study is to analyze the prognostic factors of PM from colorectal cancer following the treatment with cytoreductive surgery (CRS) + POC.
  
  
  METHODS
  During the last 8 years, 142 patients with PM of colorectal origin have been treated with CRS and perioperative chemotherapy. The surgical resections consisted of a combination of peritonectomy procedures.
  
  
  RESULTS
  Complete cytoreduction (CCR-0) was achieved at a higher rate in patients with peritoneal cancer index (PCI) score less than 10 (94.7%, 71/75) than those of PCI score above 11 (40.2%, 37/67). Regarding the PCI of small bowel (SB-PCI), 89 of 94 (91.5%) patients with ≤2 and 22 of 48 (45.8%) patients with SB-PCI ≥ 3 received CCR-0 resection (P < 0.001). Postoperative Grade 3 and Grade 4 complications occurred in 11 (7.7%) and 14 (9.9%). The overall operative mortality rate was 0.7% (1/142). Cox hazard model showed that CCR-0, SB-PCI ≤ 2, differentiated carcinoma, and PCI ≤ 10 were the independent favorite prognostic factors.
  
  
  CONCLUSIONS
  Complete cytoreduction, PCI, SB-PCI threshold, and histologic type were the independent prognostic factors.
authors.affiliation: NPO to Support Peritoneal Surface Malignancy Treatment Unit, Peritoneal Carcinomatosis Center, Kishiwada Tokushukai and Kusatsu General Hospital, 1-26 Haruki-Moto-Machi, Kishiwada City, Osaka 596-0032, Japan. y.yonemura@coda.ocn.ne.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Emel
authors.initials: E
authors.lastname: Canbay
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003082:Colectomy / Q000401:mortality*; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000628:therapy*; D004358:Drug Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000706:statistics & numerical data; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents