title: Treatment Failure Following Complete Cytoreductive Surgery for Peritoneal Metastasis from Colorectal Cancer.
abstract: Treatment failure after complete cytoreduction for peritoneal metastasis(PM)from colorectal cancer(CRC)has not been fully investigated. The present study was performed to clarify the risk factors for recurrence after complete cytoreduction for CRC with PM and the role of repeat surgery for recurrence.
  
  
  METHODS
  A total of 205 patients with CRC who underwent complete cytoreductive surgery combined with perioperative chemotherapy were investigated.
  
  
  RESULTS
  Recurrence occurred in 149(73%)patients. The 5-year overall and progression-free survival rates were 26%and 7%, respectively. By multivariate analysis, positive cytology, serum CEA level higher than normal range, and small bowel peritoneal cancer index B3 were significantly associated with reduced progression-free survival. Blood-borne recurrence was found in 62 (44%)of 149 patients. Repeat surgery was performed in 44(30%), and complete removal was performed in 28(64%) patients. Long-term survival after repeat surgery was experienced in patients with localized peritoneal recurrence and/or liver recurrence.
  
  
  CONCLUSIONS
  This study showed that a second attempt at cytoreduction in patients with localized intra-abdominal and liver recurrence is of benefit. Blood-borne recurrence was found in 44% of recurrent patients. The prophylaxis of recurrence should therefore be performed using systemic chemotherapy after CRS plus HIPEC.
authors.affiliation: Asian School of Peritoneal Surface Oncology.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Emel
authors.initials: E
authors.lastname: Canbay
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shintani
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshitake
authors.forename: Koutarou
authors.initials: K
authors.lastname: Hatano
authors.forename: Shouzou
authors.initials: S
authors.lastname: Sako
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hirano
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Mizumoto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takao
authors.forename: Masumi
authors.initials: M
authors.lastname: Ichinose
authors.forename: Kousuke
authors.initials: K
authors.lastname: Noguchi
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Satoshi
authors.initials: S
authors.lastname: Wakama
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000601:surgery*; D012008:Recurrence; D017211:Treatment Failure