title: Hyperthermic intraperitoneal chemotherapy + early postoperative intraperitoneal chemotherapy versus hyperthermic intraperitoneal chemotherapy alone: assessment of survival outcomes for colorectal and high-grade appendiceal peritoneal carcinomatosis.
abstract: BACKGROUND
  Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have improved survival for colorectal and high-grade appendiceal carcinomatosis. We compared the overall and recurrence-free survival (OS and RFS) of patients treated with HIPEC with mitomycin c and early postoperative intraperitoneal chemotherapy (EPIC) with fluorouracil versus HIPEC alone using oxaliplatin and simultaneous IV infusion of fluorouracil.
  
  
  METHODS
  Ninety-three patients with colorectal or high-grade appendiceal carcinomatosis were treated with CRS and HIPEC + EPIC or HIPEC alone. OS and RFS were analyzed using Kaplan-Meier curves and log-rank testing.
  
  
  RESULTS
  Survival did not differ between HIPEC regimens. The 3-year OS and RFS rates were 50% and 21% for HIPEC + EPIC and 46% and 6% for HIPEC alone (P = .72 and P = .89, respectively). HIPEC + EPIC patients experienced more grade III/IV complications (43.2% vs 19.6%, P = .01).
  
  
  CONCLUSIONS
  There was no difference in OS and RFS between colorectal and high-grade appendiceal adenocarcinoma patients treated with CRS and HIPEC + EPIC versus HIPEC alone. However, HIPEC + EPIC patients suffered greater morbidity, making HIPEC alone the preferable regimen.
authors.affiliation: Department of Surgery and Oncology, University of Calgary, Room 1006 & 1023, North Tower, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada. Electronic address: Jennifer.yk.lam@albertahealthservices.ca.
authors.forename: Jennifer Y
authors.initials: JY
authors.lastname: Lam
authors.affiliation: Department of Surgery and Oncology, University of Calgary, Room 1006 & 1023, North Tower, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Department of Surgery, University of British Columbia, Diamond Health Care Centre, 5th Floor, 2775 Laurel Street, Vancouver, British Columbia V5Z 1M9, Canada.
authors.forename: Yarrow J
authors.initials: YJ
authors.lastname: McConnell
authors.affiliation: Department of Surgery and Oncology, University of Calgary, Room 1006 & 1023, North Tower, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada; Department of Surgery, University of Manitoba, GF441, 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3A 1R9.
authors.forename: Justin D
authors.initials: JD
authors.lastname: Rivard
authors.affiliation: Department of Surgery and Oncology, University of Calgary, Room 1006 & 1023, North Tower, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada.
authors.forename: Walley J
authors.initials: WJ
authors.lastname: Temple
authors.affiliation: Department of Surgery and Oncology, University of Calgary, Room 1006 & 1023, North Tower, 1403-29 Street NW, Calgary, Alberta T2N 2T9, Canada.
authors.forename: Lloyd A
authors.initials: LA
authors.lastname: Mack
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000628:therapy; D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001063:Appendiceal Neoplasms / Q000401:mortality / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000628:therapy*
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil
keywords: Colorectal cancer; Cytoreduction; HIPEC; Peritoneal carcinomatosis; Survival