title: Cytoreductive surgery and intraperitoneal chemotherapy for colorectal peritoneal and hepatic metastases: a case-control study.
abstract: BACKGROUND
  Concomitant treatment of colorectal peritoneal metastases (PM) and hepatic metastases (HM) remains controversial. This study compares the cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC) treatment of colorectal peritoneal metastases (PM) with the CRS/IPC/hepatic resection treatment of colorectal PM and HM.
  
  
  METHODS
  All patients from a prospective PM registry at the Uppsala institution treated concomitantly for PM/HM with CRS/IPC/hepatic resections were included in a PM/HM-group, n=11. They were matched 1(:)2 with patients from the registry being treated only for PM with CRS/IPC, n=22. Overall survival (OS), disease-free survival (DFS), morbidity, mortality, and recurrences were compared.
  
  
  RESULTS
  The PM/HM-group had median OS of 15 months (95% CI: 6-46 months) and the PM-group had a median OS of 34 months (95% CI: 19-37 months), P=0.2. The DFS was 10 months (95% CI: 3-14 months)  and 24 months (95% CI: 10-32 months) respectively, P=0.1. Morbidity was 27% in both groups and one postoperative death in the PM/HM-group. Currently, 1/10 (10%) patients with an R1 resection are  disease-free in the PM/HM group while 9/20 (45%) are disease-free in the PM group (P=0.05).
  
  
  CONCLUSIONS
  Concomitant treatment of PM and HM with CRS/IPC/hepatic resections is feasible with no significant increase in morbidity compared to CRS/IPC. The risk of recurrences is higher in the PM/HM group with a tendency towards worse DFS.
authors.affiliation: Department of Surgical Sciences, Section of Surgery, Uppsala University, Uppsala, Sweden.
authors.forename: Frans F
authors.initials: FF
authors.lastname: Duraj
authors.forename: Peter H
authors.initials: PH
authors.lastname: Cashin
keywords: Colorectal cancer; cytoreductive surgery; hepatic metastases; intraperitoneal chemotherapy; peritoneal carcinomatosis; peritoneal metastases