title: Urological procedures in patients with peritoneal carcinomatosis of colorectal cancer treated with HIPEC: morbidity and survival analysis.
abstract: OBJECTIVE
  To investigate whether cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) is a feasible and effective option for patients with urological involvement of peritoneal carcinomatosis from colorectal cancer (CRC-PC).
  
  
  METHODS
  The characteristics of patients with CRC-PC treated with CRS+HIPEC, with or without a urological procedure, between April 2005 and June 2013 in two tertiary Centres were analyzed.
  
  
  RESULTS
  Thirty-eight patients (14%) out of 267 CRC-PC patients treated with CRS+HIPEC had a urological procedure during cytoreduction. The median survival was not significantly different between patients with or without a urological procedure (26.9 versus 32.1 months, p=0.29). Severe complications occurred more in patients with a urological procedure (47% versus 20%, p<0.001). In patients with a urological procedure, the most frequent complications were gastrointestinal leakage (n=9) and intra-abdominal abscess formation (n=5).
  
  
  CONCLUSIONS
  Urological resections as a part of CRS+HIPEC in patients with peritoneal carcinomatosis of colorectal origin are feasible and effective. Severe complications are prevalent in these patients but survival is comparable to patients without involvement of the urinary system.
authors.affiliation: Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands H.Braam@antoniusziekenhuis.nl.
authors.forename: Hidde J
authors.initials: HJ
authors.lastname: Braam
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.
authors.forename: Thijs R
authors.initials: TR
authors.lastname: van Oudheusden
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.
authors.forename: Ignace H J T
authors.initials: IH
authors.lastname: de Hingh
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, Netherlands.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
authors.affiliation: Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands.
authors.forename: Djamila
authors.initials: D
authors.lastname: Boerma
authors.affiliation: Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands.
authors.forename: Marinus J
authors.initials: MJ
authors.lastname: Wiezer
authors.affiliation: Department of Surgery, St. Antonius Hospital, Nieuwegein, Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshorst
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002277:Carcinoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D013520:Urologic Surgical Procedures
chemical_list: D000970:Antineoplastic Agents
keywords: Colorectal neoplasms; hyperthermia; intraperitoneal chemotherapy; peritoneal neoplasms; postoperative complications; prognosis; urinary tract