Cytoreductive surgery and HIPEC offers similar outcomes in patients with rectal peritoneal metastases compared to colon cancer patients: a matched case control study.
OBJECTIVE
The effect of cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with rectal peritoneal metastases (PM) is unclear. This case-control study aims to assess the results of cytoreduction and HIPEC in patients with rectal PM compared to colon PM patients.


METHODS
Colorectal PM patients treated with complete macroscopic cytoreduction and HIPEC were included. Two colon cancer patients were case-matched for each rectal cancer patient, based on prognostic factors (T stage, N stage, histology type, and extent of PM). Short- and long-term outcomes were compared between both groups.


RESULTS
From 317 patients treated with complete macroscopic cytoreduction and HIPEC, 29 patients (9.1%) had rectal PM. Fifty-eight colon cases were selected as control patients. Baseline characteristics were similar between groups. Major morbidity was 27.6% and 34.5% in the rectal and colon group, respectively (P = 0.516). Median disease-free survival was 13.5 months in the rectal group and 13.6 months in the colon group (P = 0.621). Two- and five-year overall survival rates were 54%/32% in rectal cancer patients, and 61%/24% in colon cancer patients (P = 0.987).


CONCLUSIONS
Cytoreduction and HIPEC in selected patients with rectal PM is feasible and provides similar outcomes as in colon cancer patients. Rectal PM should not be regarded a contra-indication for cytoreduction and HIPEC in selected patients. J. Surg. Oncol. 2016;113:548-553. © 2016 Wiley Periodicals, Inc.
Department of Surgical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Geert A
GA
Simkens
Department of Surgical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Thijs R
TR
van Oudheusden
Department of Surgical Oncology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Hidde J
HJ
Braam
Department of Surgical Oncology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Marinus J
MJ
Wiezer
Department of Surgical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Simon W
SW
Nienhuijs
Department of Surgical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Harm J
HJ
Rutten
Department of Surgical Oncology, St. Antonius Hospital, Nieuwegein, the Netherlands.
Bert
B
van Ramshorst
Department of Surgical Oncology, Catharina Hospital, Eindhoven, the Netherlands.
Ignace H
IH
de Hingh
D000368:Aged; D016022:Case-Control Studies; D010478:Chemotherapy, Cancer, Regional Perfusion; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome
colorectal neoplasms; neoplasms metastases; peritoneum; rectal neoplasms; treatment outcome