title: Routine second-look after surgical treatment of colonic peritoneal carcinomatosis.
abstract: BACKGROUND
  Surgical procedures that combine both complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved the survival of patients with peritoneal carcinomatosis (PC). Current imaging and laboratory investigations are not very useful to diagnose PC. This prospective study sought to determine the usefulness of routine second-look surgery (RSLS) combined with HIPEC in the diagnosis and treatment of patients with PC at high-risk for recurrence.
  
  
  METHODS
  From 2007 to 2011, RSLS was performed on 14 patients who had undergone a complete initial oncological resection for synchronous colonic PC and/or ovarian metastasis with PC discovered during primary colon cancer surgery after a course of 12 cycles of intravenous chemotherapy, eventually associated with HIPEC.
  
  
  RESULTS
  Pathology confirmed PC in 71% of patients during RSLS, with a median peritoneal carcinomatosis index (PCI) of 10. There was no post-operative mortality, while 7% of patients exhibited Dindo Grade III-IV complications. The 2-year overall survival and disease-free survival rates were 91% and 38%, respectively. Following RSLS and CCRS, peritoneal recurrence was observed in only 8% of patients who had undergone HIPEC.
  
  
  CONCLUSIONS
  RSLS combined with HIPEC after initial resection of synchronous colonic PC allows diagnosis and treatment of low-score PC, with limited post-operative complications and increased overall survival rates.
authors: Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France. Electronic address: jean-baptiste.delhorme@chru-strasbourg.fr.
authors: J B
authors: JB
authors: Delhorme
authors: Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France.
authors: E
authors: E
authors: Triki
authors: Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France.
authors: B
authors: B
authors: Romain
authors: Département de Santé Publique, Hôpitaux Universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
authors: N
authors: N
authors: Meyer
authors: Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France.
authors: S
authors: S
authors: Rohr
authors: Service de Chirurgie Générale et Digestive, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, avenue Molière, 67200 Strasbourg, France.
authors: C
authors: C
authors: Brigand
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002277:Carcinoma / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods; D003110:Colonic Neoplasms / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery / Q000628:therapy; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D011183:Postoperative Complications; D011446:Prospective Studies; D024162:Second-Look Surgery; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D016685:Mitomycin
keywords: Colon cancer; HIPEC; Peritoneal carcinomatosis; Second-look surgery