title: Colorectal peritoneal carcinomatosis treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: the experience of a tertiary Asian center.
abstract: BACKGROUND
  Compared with intravenous chemotherapy, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been shown to improve survival in patients with recurrent colorectal disease confined to the peritoneum. We report our experience with CRS and HIPEC for colorectal cancer patients with peritoneal carcinomatosis, evaluating prognostic factors for disease-free survival (DFS), overall survival (OS), and perioperative morbidity and mortality.
  
  
  METHODS
  All patients who underwent CRS and HIPEC were included in our study. Clinical characteristics, operative data, and 30-day morbidity and mortality were collected and evaluated.
  
  
  RESULTS
  Between January 2001 and December 2012, there were 35 consecutive patients who underwent CRS and HIPEC at our institution. Thirty-three patients (94%) had optimal cytoreduction. No 30-day mortality was reported, but 14 patients had postoperative complications. The median DFS was 9.4 months (95% confidence interval 5.5-18.7 months), and DFS at 1 year, 3 years, and 5 years were 43.8%, 22.3%, and 22.3%, respectively. The median OS was calculated to be 27.1 months (95% confidence interval 15.3-39.1), and the OS at 1 year, 3 years, and 5 years were 83.7%, 38.2%, and 19.1%, respectively.
  
  
  CONCLUSIONS
  CRS and HIPEC can provide survival benefit, with reasonable morbidity and mortality for Asian patients with peritoneal carcinomatosis from colorectal cancer. Patient selection and perioperative management of the patients are key to the success of the procedure.
authors: Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore; Department of General Surgery, Singapore General Hospital, 9 Hospital Drive, 169612 Singapore. Electronic address: melteo1@gmail.com.
authors: Melissa Ching Ching
authors: MC
authors: Teo
authors: Department of General Surgery, Singapore General Hospital, 9 Hospital Drive, 169612 Singapore.
authors: Grace Hwei
authors: GH
authors: Ching Tan
authors: Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore.
authors: Cindy
authors: C
authors: Lim
authors: Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore.
authors: Claramae Shulyn
authors: CS
authors: Chia
authors: Department of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore.
authors: Chee Kian
authors: CK
authors: Tham
authors: Department of Surgical Oncology, National Cancer Centre Singapore, 11 Hospital Drive, 169610 Singapore; Department of General Surgery, Singapore General Hospital, 9 Hospital Drive, 169612 Singapore.
authors: Khee-Chee
authors: KC
authors: Soo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D011183:Postoperative Complications / Q000453:epidemiology; D012846:Singapore; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin
keywords: colorectal cancer; cytoreductive surgery; hyperthermic intraperitoneal chemotherapy; peritoneal carcinomatosis