title: Influence of simultaneous liver and peritoneal resection on postoperative morbi-mortality and survival in patients with colon cancer treated with surgical cytoreduction and intraperitoneal hyperthermic chemotherapy.
abstract: BACKGROUND
  Cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy (HIPEC) has recently been established as the treatment of choice for selected patients with peritoneal carcinomatosis of colonic origin. Until recently, the simultaneous presence of peritoneal and hepatic dissemination has been considered a contraindication for surgery. The aim of this paper is to analyze the morbidity, mortality and survival of patients with simultaneous peritoneal and hepatic resection with HIPEC for peritoneal carcinomatosis secondary to colon cancer.
  
  
  METHODS
  Between January 2010 and January 2015, 61 patients were operated on, 16 had simultaneous peritoneal and hepatic dissemination (group RH+), and 45 presented only peritoneal dissemination (group RH-).
  
  
  RESULTS
  There were no differences between the groups in terms of demographic data, length of surgery and extension of peritoneal disease. Postoperative grade III-V complications were significantly higher in the RH+ group (56.3 vs. 26.6%; P=.032). For the whole group, mortality rate was 3.2% (two patients in group RH-, and none in group RH+). Patients with liver resection had a longer postoperative stay (14.4 vs. 23.1 days) (P=.027). Median overall survival was 33 months for RH-, and 36 for RH+ group. Median disease-free survival was 16 months for RH-, and 24 months for RH+ group.
  
  
  CONCLUSIONS
  Simultaneous peritoneal cytoreduction and hepatic resection resulted in a significantly higher Clavien grade III-V morbidity and a longer hospital stay, although the results are similar to other major abdominal interventions. The application of multimodal oncological and surgical treatment may obtain similar long-term survival results in both groups.
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España. Electronic address: rafa.morales@telefonica.net.
authors.forename: Rafael
authors.initials: R
authors.lastname: Morales Soriano
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Morón Canis
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Xavier
authors.initials: X
authors.lastname: Molina Romero
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Judit
authors.initials: J
authors.lastname: Pérez Celada
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Silvia
authors.initials: S
authors.lastname: Tejada Gavela
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Segura Sampedro
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Patricia
authors.initials: P
authors.lastname: Jiménez Morillas
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Paula
authors.initials: P
authors.lastname: Díaz Jover
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: José María
authors.initials: JM
authors.lastname: García Pérez
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Fátima
authors.initials: F
authors.lastname: Sena Ruiz
authors.affiliation: Unidad de Cirugía Oncológica Peritoneal, Servicio de Cirugía General y Digestivo, Hospital Universitario Son Espases, Palma de Mallorca (Islas Baleares), España.
authors.forename: Xavier
authors.initials: X
authors.lastname: González Argente
mesh_terms: D003110:Colonic Neoplasms / Q000473:pathology*; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006979:Hyperthermia, Induced; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Carcinomatosis peritoneal; Cirugía citorreductora; Cytoreductive surgery; HIPEC; Liver metastasis; Metástasis hepática; Peritoneal carcinomatosis; Peritonectomy; Peritonectomía