title: Peritoneal metastases from small bowel cancer: Results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in The Netherlands.
abstract: BACKGROUND
  Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) is currently considered the standard of care for pseudomyxoma peritonei, mesothelioma and peritoneal metastases (PM) from colorectal cancer. CRS + HIPEC has also been suggested as a potential treatment option in PM of the much rarer small bowel cancer. Therefore, the current study was undertaken to investigate the results of CRS + HIPEC in all HIPEC centers in The Netherlands.
  
  
  METHODS
  From the 4 tertiary referral centers for peritoneal surface malignancies in The Netherlands, data from all patients with peritoneally metastasized small bowel carcinoma intended to undergo CRS and HIPEC were collected between January 2005 and July 2014. Primary tumor characteristics, operative details, and survival outcomes were collected.
  
  
  RESULTS
  Sixteen of 19 patients (84.2%) who underwent explorative laparotomy underwent CRS + HIPEC. Of these patients, 81.3% were female, and primary tumors were mainly located in the ileum (50%). A complete macroscopic resection was achieved in 93.8%. Serious adverse events requiring re-intervention occurred in 25%, and no in-hospital mortality was observed. Recurrent disease was observed in 50% of patients and median survival after CRS and HIPEC was 31 months.
  
  
  CONCLUSIONS
  In a select group of patients in whom a complete macroscopic resection can be achieved, survival rates comparable with those in colorectal PM are attainable with acceptable morbidity. The role of adjuvant chemotherapy needs further research.
authors.affiliation: Department of Surgical Oncology, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Thijs R
authors.initials: TR
authors.lastname: van Oudheusden
authors.affiliation: Department of Research, Eindhoven Cancer Registry/Comprehensive Cancer Centre The Netherlands (IKNL), Eindhoven, The Netherlands.
authors.forename: Valery E
authors.initials: VE
authors.lastname: Lemmens
authors.affiliation: Department of Surgical Oncology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Hidde J
authors.initials: HJ
authors.lastname: Braam
authors.affiliation: Department of Surgical Oncology, St. Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Bert
authors.initials: B
authors.lastname: van Ramshorst
authors.affiliation: Department of Surgical Oncology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Meijerink
authors.affiliation: Department of Surgical Oncology, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Eline A
authors.initials: EA
authors.lastname: te Velde
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Akash M
authors.initials: AM
authors.lastname: Mehta
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
authors.forename: Vic J
authors.initials: VJ
authors.lastname: Verwaal
authors.affiliation: Department of Surgical Oncology, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: ignace.d.hingh@cze.nl.
authors.forename: Ignace H
authors.initials: IH
authors.lastname: de Hingh
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D000328:Adult; D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods* / Q000401:mortality; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures / Q000379:methods* / Q000401:mortality; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007414:Intestinal Neoplasms / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009426:Netherlands; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D062606:Tertiary Care Centers; D016896:Treatment Outcome